Prostate Cancer Survivors






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This forum is for the discussion of anything to do with Prostate Cancer.
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Trusting your PCa Physician's Advice

Anyone who regularly follows the posts on this forum has read enough to know that following your PCa physician's advice, without question, is not a smart thing to do.

Here are just a few examples from past listings as to why that is:

1) Personally, my diagnosing urologist gave me a Lupron shot after explaining to me that a Gleason 6 was an aggressive cancer.

2) Fred Wood posted this shameful statistic from a study at M.D. Anderson: In the cohort of 12,068 men, age 66 years and older (median age, 72 years), who were diagnosed with low-risk cancer, 70% of those 76 to 80 years old and more than half of those older than 80 years still received up-front treatment despite life expectancies of 10 years or less.

3) Dr. Brooke Jennings had this to say about the surgeons at UCLA: "Surgeons at UCLA were eager to operate on my Gleason 9, even though a radiation protocol offered literally twice the cure rate of surgery. (I only learned this later.) I'm pretty sure the rad-oncs at UCLA offered the superior protocol, but the surgeons never mentioned it. Do not trust them without talking with a rad onc first."

Now, I don't think that anybody on this site is actually recommending blindly following a physician's advice. Instead, what has been advised is that you seek a second opinion when warranted. That recommendation is certainly a sound one, but I submit that a patient needs to do more than that to keep themselves from being victimized by bad advice. The reason I say that is because the physician you turn to for a second opinion might just attempt to steer you down the wrong road as well. For example, going back to Dr. Jenning’s post, he talks about not trusting the surgeons, which indicates that more than one were recommending a course of action that was clearly not right for him. So, IMO, the answer is to educate yourself so that you can hold an intelligent conversation with your doctor about the management of your cancer, and decide for yourself if he is acting in your best interest.

In closing, I believe that this is basically what Brian Watts was saying when he stated that you should "trust your own judgement as much as, or more than your doctor's judgement. You have had more time on your case than your doctor and have had a closer look at all the details". Therefore, the response to his post was out of line (as was the follow-up. To call Brian's account of the biopsy decision an "expurgated version" and "sheer folly" is to make a statement without facts to back it up…and one of the rules of this site is to back up your opinions with factual evidence).

This one was for you Brian. Thanks for your input.

Alan M in the USA

Re: Trusting your PCa Physician's Advice

"trust your own judgement as much as, or more than your doctor's judgement. You have had more time on your case than your doctor and have had a closer look at all the details".

I disagree. Your doctor has, or should have, far more knowledge of the medical information relevant to your case. This is not to suggest that you should trust your doctor blindly, as some of my posts have made clear. However, if you have concerns about your doctor's judgement, by all means get a second medical opinion. This might well involve consulting with someone with a different specialty; if your first doc is a surgeon, ask a rad-onc, or vice versa. Then decide which doctor made the most sense, and go from there.

Re: Trusting your PCa Physician's Advice

If we have a basic distrust of our treating physician, then what purpose it served by consulting them?

Are we suggesting that a relationship twixt a treating physician and their patient based on mistrust is ideal for desired health outcomes?

Tis is not enough that one's treating physician ought not only to be able to provide expert medical advice, but they should also be very skilled with the dynamics of interpersonal relationships as well?

Would it not be perhaps more prudent for a person with difficulties in establishing a relationships based on trust, to seek out a suitably qualified therapist? Or do we view mistrust in interpersonal relationships as being consistent with a healthy mind?

best wishes