Image from 9Gag
Prostate cancer has a unique distinction when compared to other cancers. It is one of the few cancers in which men can choose their own treatment. That puts them in control but with a heavy responsibility. It is not a simple decision.
First, there is the research. It is easy finding reputable sources for information and there is plenty to choose from. But it takes time to sort through the different paths to treatment. Men may feel pressed for time because, after all, you don’t want to wait to treat a cancer.
Here is the good news. Most prostate cancers are not aggressive. They are actually slow growing. Most are so slow growing that many men, under the right conditions, can wait indefinitely to make a decision. They fall under the category called active surveillance. They are followed by the urologist who does periodic PSAs and occasional biopsies which tells him when action must be taken. Some men can go for years under active surveillance and never have the cancer treated.
Most men choose to treat the cancer and not wait. They can take up to three months to make a decision. The cancer is not going to grow enough to make a difference in that time frame. This allows plenty of time for researching and talking with other prostate cancer survivors about how they chose a certain treatment.
It can be an overwhelming burden to consider the treatment choices. Luckily, the data shows that there is little difference in outcomes regardless of which treatment you choose. In other words, your chances of the cancer not recurring or spreading are about the same whether you have surgery or radiation.
What more is there to consider when making a decision? The key lies in the complications and what you are willing to live with. Each treatment carries a risk of either erectile dysfunction, urinary incontinence or bowel problems (diarrhea). Each treatment has its own side effects. Make sure you understand the chances a particular complication can occur and the probability it will resolve.
It is unfortunate that the cost of treatment must be factored into the decision, but it is another issue to consider. For example, in some states, proton therapy is not covered by commercial insurance. Since it is an expensive treatment, men with commercial insurance policies may not be able to consider proton when making a decision. That narrows their choices somewhat. On the other hand, if you have traditional Medicare, it pays for proton treatment. Medicare Advantage plans may or may not pay.
When all is said and done, men may second guess their decision. Once again, there is good news about that. I believe most men, when asked if they would do the same treatment again, would say “Yes”. This goes back to doing research until they thoroughly understand all the treatments and implications of untoward reactions of therapy. They would say they felt comfortable with their decision since they left no stone unturned.
For anyone who must make a life changing decision such as this knows it is a daunting task. Rest assured that if you do your home work properly when deciding on a treatment and “listen to your gut”, you will make the right decision.