There is no easy way to receive the news that you have cancer of any kind, but—and I cannot say this too often‑—it is important to realize that prostate cancer is typically not a death sentence. The majority of men diagnosed with prostate cancer have Low-Risk disease and will live a normal life span. And even more aggressive High-Risk type is now being successfully treated with a combination of therapies.
Having said that, a diagnosis of prostate cancer is daunting, and once you join the ranks of the newly diagnosed, you enter into what Mark calls “a medical minefield.” While you are still reeling from shock you are required to make treatment decisions that can permanently affect your quality of life, and there are no easy answers. There are, however, a few basic things to bear in mind while you navigate the prostate cancer minefield.
1) Don’t waste energy asking yourself, “How did this happen? Did I bring this on myself?” Because regardless of your lifestyle—eating habits, exercise regime, or anything else that might contribute to getting this disease—you did not cause it. Prostate cancer is incredibly common. Like diminished sight and hearing, it comes with advancing age. In the words of one prostate oncologist, “If you are over seventy, and you don’t have prostate cancer, chances are you’re a woman.”
2) Stay as calm as possible. The very process of gathering the information necessary to make an informed decision can be scary. But do not be panicked by all the numerical tables, statistics and graphs. Statistics measure populations. You are not a statistic. You’re a person. And statistics and pathology reports do not take into account all the variables and intangibles that make you an individual.
3) Be proactive. The days of the passive patient with a “Whatever-you-say-Doc” attitude are over. The single most influential decision maker when it comes to obtaining the best care and treatment is you. Do your own research, and become actively involved with your doctor in the decision-making process. Ask your doctor about all your treatment options, and make sure you understand their short-term and long-term side effects.
4) Recognize and resist your natural
desire to rush into radical treatment. Be aware that a combination of the
urologist’s preference for surgery and most men’s “just get it out” attitude,
leads to tens of thousands of unnecessary radical prostatectomies every year.
These men would have lived just as long without surgery, without the risk of
losing both potency and normal urinary function and greatly compromising their
quality of life.
5) Even if you are satisfied with
your urologist, it is critically important to get a second opinion, preferably
from an independent board-certified medical oncologist—a cancer specialist—and
if possible, an oncologist with a specialty in prostate cancer. Obtaining a
second opinion doesn’t imply that you don’t trust your doctor. On a decision
this important, you owe yourself the benefit of more than one person’s
thinking. Be prepared for conflicting opinions, and remember to trust
your instincts about which doctor is right for you. Finding the right doctor
may require traveling to a major cancer center to talk with a leading edge
specialist.
Above all remember: if you are diagnosed with Low-Risk
disease you do not require any immediate radical treatment. You can be
safely monitored with “Active Surveillance.” When you are watched closely,
treatment can be safely delayed until there is some sign of progression.
Even then, the cancer will still be manageable. Multiple
studies clearly show that survival rates of men on Active Surveillance match
those of men getting immediate surgery. Also, be particularly careful if you
are in your 70s or 80s. Men in this age group
are rarely at risk of disease that will be clinically significant in their
lifetime, and these men have the highest incidence of overtreatment. As you
start out on your prostate cancer journey, be very aware that overtreatment of
this disease is rampant, and do not become a needless victim of unnecessary
treatment.
No comments:
Post a Comment