Endless Analysis

I recently met a guy who said he just wanted to talk about a rising PSA. A series of climbing PSA scores led his urologist to suggest the possible need for a biopsy. The well-intended advice set off a series of alarms and resulted in his spending hours researching prostate cancer on the internet. Given his high stress level, a friend suggested he called me to see if we could meet over coffee.

No evidence but searching for answers

Since there was no medical evidence that he had prostate cancer, our chat began with a brief explanation as to why PSA scores can rise. It soon became clear he wanted answers to some specific questions. At one point he took out 2 legal yellow pads filled with notes. His first question was about MiPS scoring and could such a test confirm the presence of cancer without the need to undergo a biopsy. His many internet searches had convinced him that a prostate biopsy was to be avoided at all costs due to the potential for an infection.

Finding dependable resources

As part of my work with PCa Aware, I meet a lot of men who have been recently diagnosed with prostate cancer. The first piece of advice we offer -- stay off the internet.

We always suggest that patients rely on the advice of their physicians and to seek out the support of local education groups or take the time to visit ProstateCancer.net. We encourage men to speak up and engage other men in a conversation about health. Most are shocked to discover the number of "silent men" in their circle of friends who have faced prostate cancer and never shared any information about their experiences.

Reaching out for support is a first step

I explained that a Mi-prostate score (MiPS) combines three markers – two of which are found in urine. Since it is rare for men without prostate cancer to have these specific markers, a high score may suggest the presence of prostate cancer. While the MiPS gives more information than the standard PSA test, it can not confirm the presence of cancer and only offers guidance on the possible need for a biopsy.

He had done extensive research on surgical options, types of radiation, hormone therapy, proton beam treatment, seed implants and more. The questions kept coming. Clearly, he was deeply concerned and needed to speak to someone who had walked the path before him.

The real challenge when faced with indecision

It soon became clear that his concerns were not about the prostate cancer rather he was facing a significant case of analysis paralysis. At the gut level, he was trying to avoid something that was potentially unpleasant (real or imagined). And while he was not facing a cancer diagnosis, he was making decisions based on fear. Over a second cup of coffee, he began to realize that his drive for more and more research had become an attractive excuse not to take action.

My solution, when faced with indecision, is to write down the known facts. I then ask what is keeping me from moving forward and does it make sense to do more research?

Make the most of the information you have

For me...when dealing with future prostate cancer treatments, the best course of action has always been:

• Find a medical team I trust
• Make decisions based on that trust

In end I have come to learn...whatever happens in the future, the right decision was made based on what was known at that time.