Man considering fork in a road leading to lots of doors

When Considering Treatment Options, It is OK to Change Your Mind

Following a potentially abnormal PSA result, my internist referred me to a urologist for a specialist opinion. After reviewing my PSA history, the urologist was firm: “You need a biopsy!”

“Sure I do,” I thought, “I’m young, I’ve never had an abnormal DRE, and my PSA has never been over 4.0. What nonsense! I am going to fix this with a second opinion!”

A malignancy

I didn’t fix anything at all. I received the same advice a second time, so I agreed to a biopsy. The results came back in about a week.

“There is a malignancy.” After the doctor spoke those words, I faded in and out of most everything else he said.  I noted the treatment options he mentioned, but that’s about it. Now what?

Wanting quick results

I left the urologist with appointments to see a photon radiation oncologist and a surgeon, both of whom were in the same medical group as the urologist.  I was overwhelmed, but I had a next step. Maybe I should just do whatever my doctors tell me; after all, they know best. But as I later learned, that’s not always the best approach.

It is human nature to want quick results. When faced with an attack, the typical response is to urgently defend.  The more quickly and aggressively you defend, the better off you’ll likely be. And one may never face an attack that requires a more urgent defense than a cancer diagnosis.

The need for quick results can lead to snap decisions, which typically are not the best ones. While considering treatment options, I made several of them.  But I also kept changing my mind, and like the road less traveled, that made all of the difference.

Nearly signing up on the spot

After meeting with the photon radiation oncologist, I was so impressed that I almost signed up on the spot. He was brilliant in every way. Decision made. Let’s do this! Except that I still had the appointment with the surgeon, so I might as well keep it.

The surgeon was equally brilliant, maybe even more so. He had already performed 3,700+ prostatectomies with the Da Vinci robot. Maybe surgery really is the best approach, and if so, this is the guy to do it. Ok, time to reconsider.

Hearing treatment sales pitches

But one thing to note is that successful physicians are also successful salesmen. Physicians achieve success by performing procedures, not simply by talking about them. A surgeon that has performed 3,700 surgeries has also performed 3,700 successful consultations – sales pitches – to his prospective customers. If his close rate is near 50%, it is likely that he has given the same basic consultation 7,000 times!

These presentations are expertly polished and mesmerizing. They offer satisfying answers to pressing issues. But if you go for one of them immediately, you might miss other options.

A friend's suggestion

After completing the consultation with the surgeon, I mentioned my diagnosis to a family friend who touted proton therapy. “Wow, my urologist never mentioned that,” I thought.

I looked into proton, and the more I learned about it, the more I liked it. After consulting with the proton doctor, I changed my mind for the third and final time. But more importantly, the whole process, which I chronicled in “Proton Therapy, What’s the Catch,” led to a solid comfort level with my final decision.

Making the right decision

I greatly respect my urologist, but I was disappointed that he left out the proton option. There are a variety of reasons that could explain the omission – but the ultimate reason isn’t as important as the lesson learned. When faced with the reality of prostate cancer, it makes sense to resist the urge to launch an immediate defense. You may have more time to react than you realize.

It is helpful to slow down and resist decision-making, even change directions, until all of the bases are covered.  In the process, something you don’t expect, like a chance conversation with a friend, might alter your entire trajectory. And that’s OK! The comfort level and confidence gained from the tortoise approach can lead to a much more positive frame of mind as treatment begins, and that can make all the difference.

Tell us in the comments below: how did you evaluate treatment options?

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