BY RALPH BLUM
The condition known as “selective
inattention” plagues our understanding: We
hear what we want to hear. I can think of no way around that defect. Some
things just have to be repeated. And repeated, until they sink in.
I am now approaching my 82nd
birthday, and my long and often humbling affiliation with prostate cancer began
when I was fifty-eight. A slightly elevated PSA and a “lump” in my prostate led
to a biopsy that the urologist evaluated as “suspicious for well-differentiated
adenocarcinoma.” The intervening years have given me a profound education in
taking responsibility (and at times failing to take responsibility) for
decisions that have affected not only my health but also my emotional
well-being.
If you have just been diagnosed with
prostate cancer, you are walking into the middle of what my oncologist and
writing partner, Mark Scholz, MD, calls “a medical minefield.” Choosing a
medical team that will lead you safely through the prostate cancer minefield is
arguably the most important decision you will ever make. And taking an
active role in your team is the second most important. You are the person who
has cancer, and a passive, “Whatever you say, doc,” attitude will not serve you
well.
You need to be aware that
over-diagnosis and over-treatment of prostate cancer are rampant. There are
many reasons that so many doctors over-treat and over-test, not the least of
which is that most of them are reimbursed for how much care they
deliver. In fact hospitals, doctors, medical equipment manufacturers,
pharmaceutical companies—all organizations that derive their revenue from
cancer diagnosis and treatments--have a deeply vested interest in the
“more-treatment-is-better treatment” paradigm. However, in the great majority
of cases prostate cancer is very slow growing, so there is no reason to panic,
or to act precipitously. So that for 9 out of 10 men reading this blog,
“active-surveillance” should be your first step on this cancer journey as you
weigh your treatment options—which must include the possibility of living with
prostate cancer untreated.
You also need to be aware of the
“Hammer Syndrome:” If you’re a hammer the whole world looks like a nail. To the
surgeon the best option looks like surgery. A radiation oncologist will see
radiation as the answer. A medical oncologist is more likely to suggest drugs.
It can’t be repeated too often: Before you reach any treatment decision
take the time to do as much research as possible, and make sure you explore
every option. Do not go to just one doctor and say, “Treat me.” Get a second
opinion. Ask questions. And don’t be pressured by anyone to hurry a
decision. Weigh all the pros and cons of each treatment recommended, and
look carefully at prostate cancer from the potential cure versus
quality-of-life perspective. Far too many men rush into radical treatment for
what is typically a non-life-threatening condition when their number one
priority should be guarding and preserving quality of life.
Few of us have any
objective way to judge whether a particular doctor has the medical knowledge,
skill and experience to treat our specific case with success. I have
dodged some major bullets over the years, but eventually it was my good fortune
to fall into Mark’s compassionate and capable hands. And I can tell you that confidence
in your doctor and belief in your chosen treatment are two of the great
intangibles in a successful recovery. And guess what? Your successful recovery
may include living a long and productive life with a chronic form of
prostate cancer. At least, it has
worked for me.
No comments:
Post a Comment