So Many Choices - Prostate Cancer
I'm finding that there are a lot of opinions and a lot of treatment options when it comes to prostate cancer. Talk to the men who have been through it and you frequently hear the enthusiasm that each of them has for the doctor they used and the procedure that they chose. Talk to the specialists and you'll hear about the course of care that they are focused on and the challenges that alternatives provide. The choices all come with serious side effects and a level of uncertainty. There's not an absolute direction that the medical profession has settledAdd to the mix that every man has a unique set of conditions and the cancer each of us is fighting is at different stages degrees of challenge. To say it can be confusing would be an extreme understatement.
Yesterday Cindy and I began a ten day exploration of options for my treatment. In the coming days we'll be meeting with two surgeons, two radiology oncologists, and a leader in the application of brachytherapy - the implantation of permanent radioactive seeds.
Yesterday's appointment was with Dr. Heather Cheng, a medical oncologist at the Seattle Cancer Care Alliance. Dr. Cheng deals with more advanced patients who require treatment that is determined to be chronic and incurable. Thankfully, my reason for meeting with her was for a second opinion on the status of my cancer - not because my condition is thought to be incurable.
We learned yesterday that the SCCA pathologist that reread my biopsy results assessed my condition to be slightly more aggressive than the the initial pathologist did. Using Gleason scores - a 2 to 10 scale rating the rate of growth and malignancy of prostate cancer - more of my samples are thought to be 7's and 8's. That helps to narrow the recommended courses of treatment and help influence the timing.
Dr. Cheng emphasized that she agreed that my cancer is curable and her recommendation is to pursue a course of treatment that would begin as soon as possible - hopefully before Christmas. The choices she emphasized include surgical removal of the prostate followed by radiation therapy, or radiation and hormone treatment. Each will have side effects to deal with and each requires careful consideration. She doesn't feel that I'm a strong candidate for seed implantation as a course of therapy.The thing I liked about my meeting with Dr. Cheng is that she didn't have a professional bias. She doesn't do surgery or provide radiation therapy. She was able to discuss all the options and the impact that each would be expected to have on my body.
I know that my opinion will be influenced as we go through each of the upcoming appointments. I also know that at the end of the day Cindy and I will have to own and live with the decision that we make. I can't select a treatment based upon another mans prostate cancer. Each of us has to do our own assessment and make the best decision for us.
On this Thanksgiving Day I'm grateful that my cancer was detected, that I live in a region of the United States that has world-class medical options, and for the love, concern, and prayers of my family and friends. With all that on my side this will just be a temporary speed-bump on the road of life.
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