Having the discussion with your physician about your newly diagnosed prostate cancer is stressful, nerve-racking and scary. It is important to arrive at your doctor’s appointment prepared with questions. You should have a family member, such as your wife, or a close friend, accompany you to the office visit.
Personally, I like having “cancer talks” with the patient as the last patient of the day so I can devote as much time as possible to review the patient’s situation and answer their questions. Here is a list of important questions to ask your physician at the time of your prostate cancer talk. I have tried to briefly answer some of these questions.
The appointment can be a bit overwhelming, so write these questions down and bring them with you, as well as a pen and paper to write down the answers.
1) What are the Gleason score and number of positive cores on the biopsy? This helps determine the aggressiveness of the cancer.
2) Should I have a CT Scan of the abdomen and Pelvis? Should I have a Bone Scan? These X-rays determine if the cancer has spread to other organs such as the lymph nodes and bones.
3) What are best options for treatment? This includes surgery, seed implantation, external radiation therapy, cryosurgery, watchful waiting and hormonal therapy.
4) Can you review the benefits for each therapy?
5) Can you review the risks for each therapy? The two main risks are urinary problems and erectile dysfunction.
6) Should I get a second opinion? Second opinions are very important. Although doctors are intelligent, they each have a different opinion and philosophy for treating prostate cancer.Second opinions can also be received from radiation oncologists and medical oncologists.
7) How long should I wait after the biopsy to start treatment? Typically, I recommend waiting a minimum of 4 weeks to allow swelling to resolve.
8) Is there anything I can do to get myself ready for treatment? A healthy diet, vitamin supplementation and exercise are key to overall well-being.
9) Do you have any literature or booklets to read? Does the local hospital have a support group?
10) Based on the recommended treatment, what are the chances the cancer could come back? In other words, will I need additional therapy in the future? Some forms of prostate cancer can be very aggressive, such as a patient with Gleason 9 disease. This patient may require radiation and hormonal therapy at the same time. Or a patient may require radiation after surgery.
11) What do you recommend as the best therapy for me?
12) What type of follow-up is needed after I am treated? I follow my patients closely. I get a PSA every 3 months for the first 2 years, every 6 months for the next 2 years and then yearly forever.
You should choose your therapy based on the trust in your Urologist and the information who have received. I would recommend talking with family, friends, support groups and reading reliable literature about prostate cancer. Remember, this is your life and your body. You have to make the final decision.
Published On: February 02, 2007