Prostate cancer and sarcasm-Mom I know you are listening.

My mother had many many many sayings for anything. Many to put any one of her five boys in their place. Here’s one I am guilty of in the story from “The Decision” below. I admit it… I can be sarcastic.

To quote my mother ( And I don’t know from where she heard it, but I heard it a lot from her to the point of memorization):

sarcasm is the lowest form of wit, it is usually a futile gesture on the part of the less intelligent.

From “The Decision”

On one particular occasion (however it has happened countless times) I had just told a patient that his biopsy showed cancer. I began to lay out an overview of the options and happened to start with surgery. Before I could continue, the patient told me, “My brother has a friend who has prostate cancer, and he did radiation because a doctor told him that if he had surgery he’d be impotent and that surgery lets air get to the prostate and will make it spread. My brother and his friend told me to steer clear of surgery.” Now, normally I will take a deep breath and slowly explain the pros and cons of both radiation and surgery and the concept of apples to apples, but sometimes I have a little fun showcasing the folly of how some patients will place so much credence on something someone has told them. On this occasion I said, “Mr. Jones, thank you for sharing that with me. What type of work does your brother do?” “He sells insurance.” “Thank you. And what type of work does your brother’s friend do?” “I think he builds houses.” I then said,” Okay. Based on what you have told me, this is what I’d recommend for your cancer. My advice to you would be for you to do what your brother said his friend was told by his doctor about your brother’s friend’s cancer. Do you have any other questions for me?”

Talk to any M.D., no sooner do you begin to give your advice an occasional patient will spend a part of his time with his urologist telling his urologist what another doctor told someone else. My advice…you are there with your doctor. Ask him questions pertinent to you, sap him for all the information and words of wisdom by virtue of his experience, and then do your research in making your decision. I as a doctor really have no interest in Uncle Bob’s doctor’s opinion about him. I am interested in you.

Ps— If you read this post, could you do me a favor please? I love taking pictures of landscape, water and dogs. I think they are gorgeous. Please comment if you feel they add something or detract from the matter at hand and that being understanding prostate cancer and its attendant decision/aftermath issues. Thanks, J.M.