The Decision Is Yours

An important consideration to factor into your treatment decisions is that success is not guaranteed. As many as half of the apparently localized cancers turn out, at surgery, to have already spread. And up to one-fourth, despite apparently successful surgery, will produce a recurrence over the next several years. Thus, while aggressive treatment will be unnecessary for some men, it will prove inadequate for others.

In coming to a decision, you may find it helpful to thoroughly discuss your treatment options, including benefits and side effects, with your wife/partner. You may also consider contacting your local prostate cancer support group after consulting with your primary care physician and one or more specialists. Getting a second opinion and different perspectives can be very helpful.

Your decision does not need to be rushed. Take time to explore all your options. You may prefer a teaching hospital or a cancer center for treatment, choosing a surgeon or radiation oncologist who has extensive experience in the newest, least traumatizing techniques. You may want to take part in a clinical trial evaluating new approaches. Ultimately, the decision rests with each individual. Each man has his own priorities and knows best which choices feel most comfortable for him.

Second and Third Opinions

Once you receive your doctor’s opinion about what treatments you need, it may be helpful to get more advice before you make up your mind. Other doctors’ opinions can help you make one of the most important decisions of your life. Getting another doctor’s advice is normal medical practice, and your doctor can help you with this effort. Many health insurance companies require and will pay for other opinions. Another opinion can help you:

  • Confirm or adjust your treatment plan based on the diagnosis and stage of the disease.
  • Get answers to your questions and concerns and help you become comfortable with your decisions.

You may also consider contacting a prostate cancer support group in your area. Talking with other men who have experienced the various procedures available may help you to understand better the treatment options described by your doctor.

Making Treatment Choices

If you have been diagnosed with prostate cancer, you may be overwhelmed with an array of treatment options. Your course of action will, to some extent, be influenced by the character of your cancer. Your decisions should also reflect your personal priorities after weighing each potential benefit and possible harm for the treatment options available. Your age and health and lifestyle should also be considered.

Treatment decisions are complicated by shortcomings in both prognosis and treatment. Although your Gleason score and PSA level provide good guidelines, there is still no way to know for sure how rapidly your prostate cancer will progress. Nor are there any results available from clinical trials that directly compared different types of treatment for similar stages of disease to help you evaluate possible options.

Treatment Options for Localized Disease

If your prostate cancer is confined to the gland, or localized (Stage I or II/low Gleason score), you are a good candidate for treatments that can result in long-term survival. There are three main approaches to managing localized cancer: watchful waiting, surgery, and radiation therapy.