Decision making and uncertainty
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 available to choose from.
Depending on a range of criteria, men can consider active surveillance, surgery, or radiotherapy. There is also the NanoKnife®, which is currently available in Sydney and Queensland.
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 looking at, all bring uncertainty. Common concerns include:-
- Am I making the right decision?
- Will the side-effects be worse than expected or not as bad?
- What is really the best treatment option for me?
- Will there be other effects from the 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 to even the same treatment. There is no one size fits all treatment. Obtain a second opinion to guide you towards what is best for you, not others.
Even with all the information gathered, there can still be that internal nagging voice – “I’m still not sure”.
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.
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. If you can step back for a moment and look at other events in your life where there has been some 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, relating 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 to work through your concerns.
Consider counselling to guide and support you during this transition period, to determine what is the best option for you and that you can you live with the decision that you make.
You don’t have to do this alone, seeking and asking for help shows strength, not weakness.
Lastly, consider visiting the Navigate website, an on-line decision aid for men diagnosed with low-risk, low-grade prostate cancer. Navigate is a project being run by the Peter MacCallum Cancer Centre in Melbourne, and I am the consumer advocate on the project.
Once you are registered on Navigate, you will be selected for further involvement which will go some way to assisting you to make your decision, and hopefully reduce some of the uncertainty that is churning inside you.