Post Edited (Casey59) : 1/31/2011 8:11:23 PM (GMT-7)
Post Edited (zufus) : 2/1/2011 6:11:23 AM (GMT-7)
Post Edited (medved) : 2/1/2011 11:49:06 AM (GMT-7)
“After a diagnosis of prostate cancer (PC) has been made and the initial shock of a life-threatening diagnosis has begun to lessen, the thoughts of the patient almost invariably focus on “What should I do to get rid of this disease?” Family and friends reinforce this mental set, as well as add to the anxiety of the situation by asking, “What are you going to do?”
The main focus in the context of a new diagnosis of PC, however, should not be on what particular treatment should I select, but rather on understanding the specific expressions of his illness, and how they lead to a rational choice of therapy. In such a setting or context, the patient and his team act as medical detectives¾to gather information, analyze, re-evaluate, and then begin to consider what to do.
No patient or family is magically transformed into a PC expert upon being diagnosed with this disease. Life is not that simple. Amazingly, there are patients who rise to this threatening “occasion” and educate themselves to a degree that many physicians find astoundingly impressive. Many other men delegate this empowerment process to others -- especially their wives or their partners. These men do not enter the empowerment process and do not optimize their chance of a successful outcome. They also miss the opportunity to bond with other men and/or women and the ability to not only receive guidance but to give it to others in return.
The heart of Empowerment involves taking responsibility for, and authority over one’s own outcomes based on education and knowledge of the consequences and contingencies involved in one’s own decisions. This focus provides the uplifting energy that can sustain in the face of crisis.”
These are the words of one of the recognized experts in prostate cancer, Dr Stephen Strum from an article he wrote titled “A Strategy of Success in the Treatment of Prostate Cancer.” It’s good advice, and as such, I’m not going to prematurely press the conversation into treatment choices…there is plenty of time in upcoming days to start talking about that. Others may be quick to recommend this method or that method; I’m going to tell you, however, that you don’t need to rush. In a very, very large percentage of cases, prostate cancer is not the fast-growing devil that other cancers can be. Do yourself and your husband a favor, and move at a deliberate pace to reach a treatment decision, as Dr Strum recommends.
You’ve already gotten input on getting a 2nd biopsy reading opinion…I would continue to follow through with that; this is a highly recommended “best practice.”
In parallel, I would recommend placing an online order today for a book considered by many to be the “bible” of prostate cancer: “Dr Patrick Walsh’s Guide to Surviving Prostate Cancer”. Dr Strum’s book is a good second choice, and lots of other 3rd choices… I recommend placing an order today for Dr Walsh’s book in order to start & solidify your education process.
Here’s another “tool” which I can provide for you to begin previewing. It’s called the “Guideline for the Management of Clinically Localized Prostate Cancer: 2007 Update.” It is a publication of the American Urological Association, and it’s available free online. As I already stressed, you shouldn’t be making treatment decisions now, but this will help you to frame-up a decision making process. In summary, the document guides you to closely examine four facts/dimensions about your husband in order to make the most personally appropriate treatment decision: his cancer characteristics, his overall health, his life expectancy (age), and his personality/values.
I followed this guideline fairly closely in my decision making process, and it left me with high confidence before, and after, my treatment that I had done the right thing…right for me. This guideline doesn’t steer anyone toward one treatment or the other, but helps with the decision making process. Later, if you are interested, I can/will share how I analyzed these dimensions for myself (again, my age and case sounds very similar to your husband’s).
I’m now 2-years past my diagnosis, and consider myself fully recovered…and I will probably never have to deal with PC again in my life. We have a group of guys here at this site who are at various stages of our recovery, after various treatments, who are focused on lifestyle modification to improve our longevity and quality of life…right now we are focused on a “PC/Aerobic Exercise Challenge”, but we’ve had lots of lifestyle discussions on diet/nutrition for both fighting prostate cancer and other “best practices.” The only reason I mention this now to you is that over the next several months (between now and your husband’s possible treatment), he should consider undertaking an exercise routine to get himself into the best physical shape possible. It will absolutely help in his recovery.
I hope that you take Dr Strum’s words at the beginning of this post to heart…way, way too many people rush unnecessarily into treatment discussions and decisions. I encourage you to get a complete understanding of your husband’s case, learn about all the treatment options, and follow the decision methodology to explore what’s important.
In your learning process, don’t be shy about seeking the best doctors at the Comprehensive Cancer Centers I previously listed…they all take insurance just like all the other doctors. I’m in Chicago-area, and only know names of doctors in your area that I’ve read about who are very highly regarded. I could send some of those, but hopefully others with first-hand experience with those docs will also chime in.
Gosh I love this site...this is what it is all about, great info in this post..
Good luck Diamonds, not a darn thing I can add .
Diamonds............you've received quite bit of good advice here from other members. Just wanted to add that I and several others had Davinci surgery with Dr. David Lee at U.of Penn. At the time of my surgery, he had performed over 1800 (1/26/09)...he is now over 2000. All of us on the forum who have been treated by Lee are pleased with the results and care. I'm not advocating surgery over any other treatment, just giving you names and my experience. I also consulted Dr. David McGinnins of Bryn Mawr Urology, and I think he is affiliated with Jefferson Hospital. I could have easily gone with him, and at the same juncture, had performed 800 Davinci surgeries, and many more opens...........I also had my biopsy slides sent to Epstein at Hopkins for second opinion. Since I live in Delaware, I consulted with Dr. Donavanik (brachytherapy) at Helen Graham Cancer Center, and consulted with Steven Grubbs, a medical oncologist there. I'm being followed locally by another terrific urologist, Thomas Desperito, who does Davinci, but had not performed enough at the time for me to feel comfortable, even though he trained under Lee. You're fortunate that you live so close to so many good options.........just trying to give you a few specifc names to chew on.
Arnie in DE