Decision making & uncertainty

Choosing the "right" treatment

When men get a prostate cancer diagnosis, the next discussion is usually about treatment. The stage of the cancer will determine the type of treatments on offer.  Generally, with a diagnosis of low-risk, low-grade prostate cancer, men will often have several options to choose from.

Depending on a range of criteria, men can consider active surveillance, surgery, or radiotherapy.  There may also be options like the NanoKnife®, or other focal therapies.

Active surveillance delays dealing with the two major side-effects of surgery and, to a lesser extent, radiotherapy – incontinence and erectile dysfunction.

Whatever treatment men are offered, all bring uncertainty.

Common concerns include:

  • Am I making the right decision?
  • Will the side-effects be worse than expected or not as bad?
  • Is this really the best treatment for me?
  • Will there be other issues after treatment that I don’t know about?
  • I’ve heard stories about other men – will those things also happen to me?

To work through this maze of questions and worries, it can be helpful to visit a Prostate Cancer Support Group to hear other men’s experiences.  Just remember, every man will respond differently, even to the same treatment.

There is no one-size-fits-all treatment.

Why am I still uncertain?

Even with all the information gathered, there can still be that internal nagging voice – “I’m still not sure”.

One helpful option is to get a second opinion to guide you towards what is best for you, not others.

Part of the problem is that men, in general, are fixers.  We have a problem and generally we know how or what to do to fix it, but prostate cancer is a whole different kettle of fish.

At the low-risk stage, men are presented with options, and fixing the problem is not at all straightforward.  There are so many shades of grey and no guarantees.

For many men, they would love to hear “this is the treatment for you, these are the side-effects, and it will work”.  End of story.  Unfortunately, there might still be some level of doubt.

Take a step back for a moment and remember other events in your life where there has been uncertainty around decision-making.  Consider what you did then with the uncertainty, and what you learned that might help you now.

There is no simple answer when dealing with the uncertainty of decision-making, and the consequences of that decision when it relates to prostate cancer.

If you are stuck in this stage of uncertainty, seek out relevant information, talk to support groups or individuals who might have been in a similar situation.

As uncomfortable as the uncertainty is, be prepared to sit with it, with the anxiety of these uncharted waters.  Talk to your family, or close friends.

The Cancer Council has a help line (13 11 20) where you can talk one-on-one with a trained Cancer Council staff member to work through your concerns.

Consider seeing a counsellor to guide and support you during this transition period.  This may help to determine what is the best option for you so that you can live with the decision that you make.

You don’t have to do this alone.  Seeking and asking for help shows strength, not weakness.

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