Making decisions while under pressure
You have time to take a breath and slow down before making any decisions about treatment. Prostate cancer can develop into a deadly disease, but today, at time of diagnosis, it is not usually in need of immediate, emergency treatment.
Your first task, with your doctors' help, is to get information about what grade and stage of prostate cancer you have.
Your second task is learn about which treatments offer you best outcomes in long-term survival and side effects.
You're the man with cancer and medical information about cancer may be quite new to you and hard to listen to. So what you can to make it easier on yourself.
A few practical steps will help you get organized and keep track:
- Bring someone else with you to your appointments.
- Bring a notepad and tape recorder to the appointments.
- At home, set up a calendar, a phone number book and a file box (or file drawer) and a loose-leaf ring binder.
- Use the file for your new medical records, medical bills and health insurance papers, and for print-outs from reliable sources like medical journals.
- Use the binder to list your own questions and to jot down your doctors' replies. If you prefer to use a small notebook in the doctor's office, tape your notes into the binder when you get home.
- If you wish, jot down or tape in information from outside sources like books, pamphlets, and computer print outs. Family, friends and support group members may be able to help you gather and sift information. Select from this assorted material the most important points that may affect you. These are points you want to boil down and bring up with your doctors.
- Nothing is too dumb (or too clever) to ask.
- If you need privacy to talk to your doctor about impact of various treatments on sexual desire, lovemaking and erections, or bladder and bowel control, say so.
- Expect any doctor you would care to allow to treat you to be interested in your overall health and wellbeing and to see you as an individual with cancer not as a statistic or person of a certain age.
- But don't underestimate the value of statistics and "cancer numerology." Graphs and studies tell a story about human beings.
- Seek a second opinion about your biopsy.
- Seek second opinions and, if needed, third opinions or more about your treatment options.
- If you're considering either surgery or radiotherapy (external beam or brachytherapy), find a practitioner who has done the procedure many times. Usually, this means going to a major hospital recognized as a national cancer center. Prostate cancer has no single best treatment. But evidence has shown that some practitioners are "artists" and quantity of experience also counts.And the quality of equipment used (especially for exernal beam radiation) is key. Urologists (surgeons) and radiologists who are leaders in their field and have treated the most patients do a better job.
- Take some time to consider the information you have been given before you make a final decision.
In many situations in life we don't make optimal choices, "we choose the first reasonable option, a strategy known as satisficing." Satisficing is OK if there's no big penalty for choosing wrong.
As anyone who has been in combat will know, in many life and death situations reliable, experienced leaders do not carefully gather all available information and come to a rational decision. A study of fire commanders found that they "took the first reasonable plan that came to mind and did a quick mental test for problems. If they didn't find any, they had their plan of action."
Some of the best cancer doctors are trained to be able to "take the first reasonable plan," do the quick mental test for problems and, if none jump out, to sell that plan of action to the patient.
It's your body and your life. You want to stay healthy, productive and active for as long as you can. More than one treatment type might work equally well for you. For some men, no immediate treatment may be the best decision. Don't lose sight of the fact that you probably have just one good chance of a cure. It's worth bucking the urge to "satisfice" too soon. Do the best that you can to make the right choice for yourself. Don't sell yourself short.
This page reported by J. Strax, last updated Sept 20, 2004
