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Dealing with a Prostate Cancer Diagnosis

Treatment Discussion Guide: How to Open a Dialogue With Your Physician

(Read time: 5 minutes)
This article is not intended to replace professional medical care or advice. If you have any questions or need additional information, please talk with your doctor.

If you or a loved one is diagnosed with prostate cancer, you will probably have a lot of questions and concerns. Prostate cancer can be a very complex disease. Getting answers can help you feel more confident in your treatment options and your situation as a whole. That’s why The American Society for Radiation Oncology (ASTRO) states that an open dialogue between prostate cancer patients and physicians is crucial when choosing your prostate cancer treatment.

With such a diverse disease, prostate cancer treatment is not a one-size-fits-all solution. What works for one patient may not work for another. Every prostate cancer patient has to consult with their doctor, and ideally get a second or even third opinion before deciding on their treatment path.

When the risks, benefits, preferences, outcomes and costs of various treatment options are weighed, they can deviate significantly from one man to another. That’s why it’s so important for patients to have open and candid conversations with their physicians about the disease.

The American Cancer Society (ACS) has advised men to consider all available resources, engage in conversation with their physician, and weigh the benefits and drawbacks of treatment before making an informed decision.

I’ve been diagnosed. Now what?

If you’ve already been diagnosed with prostate cancer, it’s time for a different conversation with your physician. You should ask as many questions as possible about your diagnosis. Some of the questions you might discuss with your physician include:

  • What does my PSA level mean?
  • What does my Gleason score mean?
  • What is the stage of my cancer?
  • Has my cancer spread and if so, how far?
  • What additional tests should I/do I need to take?

Getting a second opinion before deciding on a course of treatment is advised by most health care professionals. In fact, some health plans even require a second opinion, according to the NCCN.

Don’t be afraid to ask your doctor to refer you to a colleague for a second opinion. A second doctor should receive your test results, a DVD copy of imaging tests, and copies of the pathology report for the most accurate diagnosis.

How do I decide on a treatment plan?

After you’ve been diagnosed and had your diagnosis verified by a second or even third physician, it’s time to discuss your treatment options before deciding on the best plan of action for your type of prostate cancer. As an example, having an initial conversation about risk factors is a good starting point for talking about options to treat the cancer.

If you decide to move forward with treatment options for prostate cancer, either because your doctor recommends it or because you decide to on your own, the need for frank discussion is more important than ever.

And although discussing factors like life expectancy can be difficult, they are crucial to a patient’s health care, according to the National Comprehensive Cancer Network’s (NCCN) Guidelines for Patients. It’s important to know as much as possible, both for yourself and your family.

Gathering information about your treatment options:

  • What are the different treatments for my condition?
  • What will the preparation for treatment look like?
  • What will the duration of each treatment be? What about the entire treatment plan?

Deciding on a treatment plan:

  • What are all the treatment options for this stage of cancer? Which of these options are
    available at this facility?
  • How soon must a decision on treatment be reached?
  • What is X treatment like? When/Where/How does it happen?
  • What are the expected side effects and risk factors with X form of treatment?
  • What are the chances that I will suffer from complications during or after treatment?
  • What advanced technologies do you offer at this facility that can help reduce the risk of
    side effects?

What treatment is right for me?

It is recommended that you meet with at least three different specialists: a urologist, a radiation oncologist, and a medical oncologist. Gathering information from each can help make a fair and balanced decision on the best treatment for your situation (and the best possible quality of life).

When meeting with these specialists, it’s important to come prepared with the right questions. Below are detailed questions you can discuss with your doctor to make sure you’re informed
about your unique situation:

  • Is radiation therapy or a prostatectomy (removal of the prostate) recommended?
  • Should we consider laparoscopic or robot-assisted prostatectomy?
  • Which kinds of radiation therapy would treat my cancer best?
  • Are there other alternative treatments that may work?

In addition, you should also ask questions about how your quality of life may be impacted:

  • Will there be an impact on my daily routine?
  • Will I be able to continue to work?
  • What activities will I still be able to do?
  • What activities are not recommended during each type of treatment?

You should follow-up every question with “Why?” or “Why not?” to ensure that you understand every possible facet of your treatment options. That way, you can make an informed decision. Asking these important questions will also give you insights into your treating physician.

What sort of side effects can I expect during treatment?

Once you’ve decided with your doctor on the best treatment plan for your stage of cancer, it’s time to learn everything you can about the treatment itself, how it will impact your lifestyle, and any potential side effects that may occur during or after treatment:

  • What are the expected side effects and risk factors with my treatment?
  • What are the chances that I will have problems with incontinence or impotence?
  • What are the chances that I will have other urinary or rectal problems?
  • Should I be worried about sexual/urinary problems or bowel dysfunction after treatment
    has ended?
  • Is there a chance the cancer will come back after treatment?

Assuming you are moving forward with the best and most appropriate treatment plan for your situation, understanding the potential treatment side effects and preparing for them ahead of time will go a long way towards improving your quality of life.

Don’t be afraid to ask any question that comes to mind

Knowledge is power. Don’t be afraid to ask questions and speak your mind. Prostate cancer is life-changing, which is exactly why you owe it to yourself to learn everything you can about it.

Click here for a printer-friendly version of this discussion guide that you can bring in-person to your next appointment with your doctor.

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1. ASTRO. (2019). – American Society for Radiation Oncology (ASTRO) – American Society for Radiation Oncology (ASTRO). [online] Available at: https://www.astro.org/News-and Publications/News-and-Media-Center/News-Releases/2016/Dialogue-between-patients-andphysicians-criti-(1) [Accessed 23 Aug. 2019].
2. Cancer.org. (2019). Finding Prostate Cancer Early. [online] Available at: http://www.cancer.org/cancer/prostatecancer/moreinformation/prostatecancerearlydetection/prostate-cancer-early-detection-finding-prostate-cancer-early [Accessed 23 Aug. 2019].
3. Nccn.org. (2018). NCCN Guidelines for Patients. [online] Available at: http://www.nccn.org/patients/guidelines/prostate/files/assets/common/downloads/files/prostate. pdf Page 27 [Accessed 23 Aug. 2019].

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