Sunday, December 10, 2017

Questions to ask YOURSELF in deciding on a primary therapy

• Do I need to see a pathology report to tell me how contained it was?

• If I choose radiation, can I live with the fact that PSA goes down over a number of years, with bounces along the way, and never becomes undetectable?

• If the pathology is adverse and PSA does not become undetectable, am I prepared to undergo adjuvant radiation with all the potential side effects that entails? (Your doctor has hopefully run a nomogram showing the probability of this happening)

• If the radiation doesn't work, am I prepared to have a biopsy and possible focal brachy re-treatment?

• Which bothers me more - the potential for incontinence and ED after surgery or the potential for retention and irritative effects after radiation? (given the probabilities of those side effects)

• Do I understand the other possible side effects of surgery? (e.g., infection, hernia, climacturia, penile shrinkage, stress incontinence, etc.) Am I prepared to take on penile rehab?

• Do I understand the other possible side effects of radiation? (e.g., fatigue, proctitis, hemorrhoids, frequency, urgency, burning while peeing, ED).

• Am I prepared to undergo radiation therapy and its side effects?

• Am I prepared to undergo surgery and its recovery?


  1. I suggest adding something like:

    o How would I compare the expertise, experience, and commitment to his or her patients of the surgeon or radiation oncologists available to me? Choosing a knowledgeable, skillful, careful, honest, and committed doctor can be the most important choice of all.

    o Run from any doctor who says his treatment has no side effects and very high success rates. His greatest expertise may be BS.

    1. Here's some advice about choosing the right doctor: