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No Regrets After Treatment

Last updated: January 2023

Because of my involvement in support groups, I am often speaking with men who have gone through some form of prostate cancer treatment. It's not unusual to find men some 2 to 5 years later telling me they wished they had known more before deciding on treatment options for their cancer.

Time and time again I find people with what appears to be a certain level of “disconnect” when it comes to understanding pre-treatment expectations and the actual outcomes of prostate cancer treatment. The realization and true impact appears to hit home several years later.

Disconnects I see

The more I become involved with post-op patients the more I believe neither men, nor their doctors, possess a true understanding of the quality-of-life issues men may face for the duration of their lives. While it is true there is no way to know or predict how things are going turn out, I suspect if men took the time in advance of a diagnosis to gain a better understanding of possible outcomes, they might be better equipped to decide when and if that time comes at a future date.

Where I see the most disconnects with men and prostate cancer treatment seems with those men who quickly decided on some form of immediate curative treatment for a low-risk cancer. Typically, these men tend to score low on the Gleason scale as in a Gleason 6. Once the Gleason score is G7 or higher, I've found most men appear more satisfied with whatever treatment they finally decided on.

Another disconnect is a total misunderstanding of two phrases: active surveillance and watchful waiting. While I often hear the terms used interchangeably, in reality they are quite different. Active surveillance is delaying immediate treatment and opting instead for close and frequent observation of any developing changes. Watchful waiting on the other hand is typically reserved for men who may be facing a low-risk prostate cancer or may have a shorter life expectancy due to age or other comorbidity complications.

Have a conversation with your doctor

If nothing else, I think men should have a conversation about prostate cancer with their MD, particularly if someone in the direct family line has had prostate cancer or if a female member in that same direct family line has experienced breast cancer (the BRCA gene can play a role in that case).

I find men are often unclear or uninformed when choosing between surgery or radiation as a first-step treatment option. I've spoken to countless men who believed that radiation did not have similar side effects to surgery.

Everyone's experience is different

My advice for all men is check out sites like ProstateCancer.net, and attend in-person support groups with men who have gone through treatment. Always remember prostate cancer is a highly individualized disease, so one man's experience with treatment can differ dramatically than your own.

When you hear the words "you have prostate cancer," stay calm. While prostate cancer can change your life, it's also important to realize that with the right care and treatment, you can adapt to the changes and live a long and productive life, too.

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