Treatment 'chart'?

I believe that it would be helpful
if you continue to post in one thread...........thanks

Treatment Options
Worried,

I think it is very astute of you at this early date in the diagnosis process to begin thinking of potential options, side effects, and other impact on your life.

When I was diagnosed in March 2010 I ended up seeing six different specialists and read several books about prostate cancer. To help me make a decision I eventually constructed a matrix where I plotted the various cancer treatments I considered against such things as insurance coverage, out of pocket costs, recovery time, convenience, time to administer, potential side effects for sexual function and continence, relative efficacy, and comfort levels with the physician or procedure, and overall quality of life issues. The treatment options I considered were open RP, robotic RP, IMRT, HD Brachytherapy, brachytherapy, SBRT (CyberKnife and Varian), cryosurgery, active surveillance, and HIFU.

As I racked and stacked these choices I applied a subjective evaluation to my individual quality of life standards as individual priorities are different for everyone. In my mind, for example, quality of life was more important than quantity of life but I realize that others can easily have different perspectives on this issue.

In any event the process helped me crystalize in my mind what was really important to me and rule out potential treatment choices. In my opinion, there seem to be way too many choices with signifiant ramifications out there for most lay patients to comprehensively consider. My personal matrix helped me make a final decision rather quickly after I had done my research. The point here is that it was done AFTER I had done quite a bit of research and met with many specialists.

I know you're looking for some kind of shortcut to the process here and I don't fault you for that but frankly, I don't think there are any. You and your husband have to go through the process you're going through now in terms of research, worry, evaluation, and decision making. It's the process that educates you and causes you to focus on what your individual priorities are.

I've often thought that our process in the United States should include an independent ombudsman to help newly diagnosed patients through this process. I think it would do a lot to reduce over treatment and help empower patients through knowledge. Many patients seem to just do whatever the diagnosing urologist tells them to do without any further research.

If you haven't found it already, the link below is a good resource to begin cataloging information on the various treatments and options but I would encourage you to do more than just read about them online. After your husband receives his biopsy results I encourage you to actually go and talk to specialists in the treatment areas that are applicable to his diagnosis so you can learn more than what you can just read about.


http://www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-cancer-additional

Best,

K

worriedabouthubby said:

Thanks and note to Kongo
Thank you all for your responses.
Kongo- I am continuing to look at sites and read as much as I can about all the treatments. I have found a few easy to access and relatively easy to understand sites and a few 'charts' that have some of the info I'm looking for. I'll share them later as I have time. I HOPE hubby will consider talking to multiple doctors- but am not certain that I can get him to do so. He can be very stubborn at times. The Cancer Treatment Centers of America seem to take a multi-disciplianry, patient centered, patient decision driven approach. They apparently lay out all the options (even ones they don't offer) and TALK with you about implicaitons, side effects, costs, etc. The also encourage care givers to be actively involved in the process. I am going to try to convince hubby to go to the new Atlanta facility (only about a 4 hour drive from us), if his biopsy comes back positive. With his PSA scores (73, 81), if even one of the six is positive, I think we will need to consider some kind of active treatment. I honestly feel that many omre than one will be positive and that we may be dealing with a cancer that has spread. I know he'd rather is be contained and like to think that surgery or brachy therapy (or similar) will rid him of it. But I just can't thnik like that right now. Thus my drive to learn about ALL possible treatments- even those for metaztisized cancers. Well... only about 24 hours utill we know a bit more. Knowledge is indeed power....... at least over my own reactions, etc.

Stubbornness
Worried,

Many people tend to discount advice that comes from those close to us. We all approach a cancer diagnosis differently. Your husband may benefit from talking one-on-one with other men facing a similar diagnosis and there are probably support groups in your area. Your doctor or a local hospital that treats cancer should be able to point you in the right direction.

I have never dealt with Cancer Treatment Centers of America but a multi-disciplinary approach at a single institution seems like a good idea. BTW, every urologist is required to counsel their patients about the different treatment options, even if they don't perform it. Of course this is a subjective discussion and the doctor will be talking from the perspective of his own specialty, training, and background. Urologists almost always recommend surgery. Radiology Oncologists will emphasize radiation therapy. The frustrating and confusing part of this for lay patients is that many of the so-called experts will have diametrically opposing views on the best treatment choice. I think many men often default to the doctor they see first or the one who suggests something that they already have in their mind. In the initial process very few patients, in my opinion, take an open and ecumenical approach to trying to sort it out.

The other aspect of this whole cancer things is that you will know a lot more in a year or so than you do now. We seem to get it AFTER we have made our treatment choice.

The conditions you describe suggests that your husband ought to be primed to make a decision as quickly as possible as his PSA hints at what might be an extensive cancer diagnosis. I hope it's not but obviously you have to be prepared for whatever the biopsy report eventually shows. Just because he has to make a relatively quick decision doesn't mean it has to be the first one offered to him. I hope you're successful in getting him to see other doctors.

K

worriedabouthubby said:

Found a Chart!!!
Found a great, interactive treatment chart!!!
here's a link

http://www.prostate-cancer.com/index.html

Great
This was great!! I have been trying to create a chart like this. This is a very good start.

Thanks for posting it

David