Your Total Picture
Cancer treatment is a choreographed balance between the treatments being administered and the patient’s ability to tolerate resulting side effects.
As a Patient with prostate cancer, you should know that each treatment modality produces its own side effects. You will need to consider which side effects you’d find tolerable. Some men, for example, cannot imagine living with side effects such as incontinence or impotence. Other men are less concerned about these and more concerned about survival. It’s most likely that your cancer is in the early stages and was found on the basis of an elevated PSA level. Although it is likely that, if left untreated, your disease will allow several years before your symptoms develop and several more years until this disease causes your death, a decision is needed; and this decision will affect you immediately.
The process of determining the best possible treatment plan for your prostate cancer is far from being a logical math equation, where information is plugged in and the right answer appears on a computer screen. Rather, the decision is made by carefully considering your total picture, which is made up of multiple factors; all of which are likely to be weighted differently by different individuals, based on their lifestyles.
When we meet, we will discuss your total picture as a team, and how it guides your treatment options.
Here is my list of the elements that comprise your total picture:
- PSA Level - lower PSA blood test values, or PSA level tend to correlate with lower cancer burdens and lower cancer stages. Your PSA level will direct your overall assessment, and will be a key element in determining treatment options and expectations.
- Gleason Score - Gleason scores correlate with cancer aggressiveness and, along with PSA level, will direct workup, treatment and expectations of outcomes.
- Digital Rectal Exam - Cancers that are palpable (able to be felt) are generally more extensive than those found on the basis of an elevated PSA level, alone. Results of this exam will provide another aspect in determining your cancer’s aggressiveness.
- Age - It is important to understand that I do not have an absolute age cutoff for any treatment. Age must be viewed physiologically, as well as chronologically. A physically-active 65-year-old may have a better age profile than a sedentary 50-year-old. In other words, sometimes you really are only as old as you think you are.
- Medical History - Many health conditions will influence the determination of what may be the best treatment for you. Some health problems may increase your risk of complications resulting from one treatment over another. Your overall health status must be taken into account before a final treatment decision is made.
- Surgical History - as with your medical history, prior surgeries (and how you tolerated them) may preclude one treatment or another.
- Social Supports - your support system will play a large part in your ability to accept the risks inherent in any treatment plan and how these risks might create or increase stress. Emotional support factors like work, family, friends, community and religions support systems are considerations in making your final treatment decision.