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Prostate Cancer Choice a Coin Toss?

Uncertainty, Faulty Info Confuse Men Facing Prostate Cancer Treatment

Choosing a Prostate Cancer Treatment

Every expert who spoke to WebMD said the same thing. Eventually, a man facing prostate cancer will ask his doctor, "Doc, what would you do?"

"It is my personal belief that a doctor should not say what he or she personally would do," Wilt says. "Unless they come back with a treatment choice that I think is out on the far end, I just would not know what I would do, or what I would tell my father to do -- because my father and I are not you."

Wilt, Smith, and Zeliadt say it's essential for a man to consider each of the possible side effects of treating, or not treating, early prostate cancer. They also agree it's essential for every man to make his own choice.

"My job is to give you the information in the most balanced way and to understand what is most important to you," Wilt says. "That allows me to support you in that choice no matter what happens."

Zeliadt suggests that men focus on their own situation and on their particular needs.

"I would encourage men to forget all the information they have heard from other men. It probably does not apply to their scenario," Zeliadt says. "They should really think about how they would adjust to the different side effects of treatment and have that be an important consideration. There is probably not a wrong decision about survival you can make. All the different treatment options are pretty close to being excellent. And that includes watchful waiting."

When a man does make his decision on prostate cancer treatment, Smith says, he tends not to regret it -- even if the outcome isn't as good as he'd hoped.

"The real issue for the doctor is how do you prepare and present authoritative information so that whatever decision the patient makes, he feels he made the right one at the time and knew what to expect afterwards," Smith says.

Unfortunately, there's still a long way to go before doctors can offer men more help with these questions.

"We may have been placing a lot of emphasis on questions about testing, and we need to place more emphasis on questions about treatment," Smith says. "Because men have to feel confident later that they had made the right decision."

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