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Informed Decision Making
Is this rise in the PSA significant? Do I have prostate cancer
or not? How can I know what to do?
The most important question that will have to be answered is: "Is
the tumor contained within the prostatic capsule or not?"
The correct answer here will determine whether or not you will be
a good candidate for surgery or other invasive technique. Many studies
show that the primary therapy fails in a high percentage of cases
because extracapsular penetration, or migration to the lymph nodes,
had already occurred prior to the procedure.
With the trend towards "Informed Decision-Making", the
patient is expected to assume much more of the burden of deciding
which treatment therapy to choose. You must gain all of the information
needed and develop a strong partnership with your medical team to
be able to make the right choice for your particular situation.
I cannot emphasize enough the importance of having a family member
or close friend being with you at all appointments to insure that
you get the information you need and that the doctors hear the concerns
you want to get across.
You must also be aware that every doctor is a product of their
training and experience; urologists are surgeons, thus they look
for surgical solutions for the therapy first – and the same
goes for radiation oncologists, etc. You should look to have a 2nd,
3rd or 4th opinion from different perspectives (one should definitely
be with a medical oncologist) and then choose the one that will
give the best hope for a cure, or control, and also insure the best
possible quality of life for you and your family afterwards. You
also need to be certain that the doctor sees more than just an "organ"
and views you as a whole person with certain lifestyles and expectations.
Lastly, don't underestimate the importance of the nurse in this
equation. She, or he, will have had extensive experience in all
aspects of dealing with cancer patients and can often provide points
of information that you neglected to get from the doctor. They can
guide you as to what to expect pre- and post- treatment and will
always be there to give you the emotional support that is often
needed as you go through a diagnostic and therapeutic process that
can strip you of your dignity and self-image.
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