Professional Opinion

prostate_logo movember_logo During my Movember series of blog posts concerning prostate cancer, a close friend mused, “I wonder what the medical folks would do themselves?”. “Excellent question”, I said, rapidly planning another Movember article, “I have some input on that topic”. The “would do” of course, related to a professional’s choice given the treatment options with which I’d been presented. To recap, my options were:

  1. Watchful waiting (i.e. just keep an eye on it until it gets more serious);
  2. Radiotherapy;
  3. Hormone therapy;
  4. Radical prostatectomy (surgical removal of the entire prostate).

I’m going for #4, surgery.

The first thing to point out is that, when acting in a professional capacity, a medical professional isn’t permitted to make a blunt recommendation. Their job is to provide sufficient information concerning what each option entails, assessments of risk, potential benefits and possible detrimental side effects, such that a patient draws their own conclusion and decides for themselves. Quite clearly, given the variety of side-effects allied to the various options, the most appropriate choice for a particular patient would be influenced by personal situation. They may, for example, still be trying to start a family.

That said, I am fortunate enough to know a couple of nurses. Knowing my personal situation and acting purely in their capacity as friends, there is nothing wrong with their letting me know their opinions. In fact, I welcomed them. One suggested:

… you are totally right in selecting option 4, as you say the rest just prolong matters.

and the other:

I’m with you on the surgery, watchful waiting would never be an option for me, and the side effects of radiotherapy and hormone treatment can, in my opinion, sometimes outweigh the benefits.

OK, a couple of thumbs up so far. [Ed: do those constitute “likes” as in facebook, these days, I wonder.]

When we were Meeting the Surgeon, I suppose because he was male and in possession of a potentially troublesome prostate himself, I was particularly interested in an aside he made while discussing things with us and jotting notes:

I’m not allowed to make recommendations but, if it were me, this is what I’d be doing.

Another “like” from the guy with the scalpel. Of course, he is a surgeon so may be inclined to favour the surgical approach. I was reminded, just a little, of another occasionally useful phrase from the management manual in the days of business bullshit:

When the only tool in your toolbox is a hammer, it is tempting to regard every problem as a nail.

Amusing such phrases may be and some certainly can be true on occasions but, in this case, I think not.

I can’t be certain what I’d be thinking if I’d encountered someone suggesting an alternative course of action but I’m not and it feels good to have these validations. I’m so comfortable with my chosen course of action that I really don’t think that any gainsayers would make me think surgery were not my best choice.

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