The co-authors of Invasion of the Prostate Snatchers, blog alternate posts weekly. We invite you to post your comments.

Tuesday, December 23, 2014

In Praise of Feisty Patients


I have learned through personal experience that there is an art to being a patient. You must choose wisely when to submit and when to assert yourself, especially if you have just been diagnosed with prostate cancer.

Because prostate cancer is so common, and in most cases so slow growing, to submit  to any form of radical treatment without doing your due diligence, could be a serious mistake and hugely detrimental to your quality of life. Yet most doctors you consult will advocate some form of radical treatment. It’s what they know, what they do. And it goes against the grain for both doctors and patients alike to put off treating prostate cancer.

However,  let’s take a moment and put things in perspective. Fifty percent of older men have the disease, live with it, and die from something else—sometimes without ever knowing they had a life threatening condition. Furthermore, the life expectancy of men with recurrent prostate cancer often stretches out well past a decade. And yet the radical prostatectomy-- one of the most complex and challenging surgeries because the prostate is located in absolutely the wrong place for a simple surgical solution—is still the most widely recommended treatment option, the most often unnecessary, and the one most likely to leave you incontinent and/or impotent.

My own experience with urologists has not always been a happy one. Twenty-five years ago, a Honolulu urologist who wanted nothing but patient compliance, told me that if I did not agree to immediate surgery I would be dead in two years. His recommendation and prognosis were not only wrong, but in my opinion violated the ancient medical precept incorporated in the Hippocratic Oath: “First do no harm.” Fortunately I was not the kind of patient to be easily intimidated.

My decision to engage in watchful waiting, monitor the cancer and take the time to educate myself, has given me almost three decades of quality time with my wife that almost certainly would have been lost or diminished if I had committed to immediate surgery. The feisty, “difficult,” assertive patient, the one who challenges the doctor, is often the one who has the best outcome.

If I had it all to do over again, I would seek to change nothing.


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