First of all, if he had any type of medical problem it would change his perspective on things. From a marketing standpoint, Sheen has been brilliant. Maybe he has been held back by the traditional roles and media (movies and tv) and has been yearning for something new. I understand he has sold out a live show in New York at the Radio City Music Hall. I’d go to see what he’s about. Is he exploding, imploding or is he brilliant. He doesn’t really look well to me…maybe he is sick from something.
Anyway…Robert DeNiro chose to have his prostate removed. So did Arnold Palmer. Rudy chose seeds. The people writing books with titles like….cure without the knife or beware of a urologist taking your prostate from you etc…all used radiation of some sort. The really “smart” and informed patients who have the money to do it….might consider non FDA approved methods and go out of the country for a treatment. John Wayne? He’d have it out by the open method. James Brown…he chose cryotherapy.
Now hold on a minute….am I being sarcastic…well yes but don’t get me wrong. I think there is promise for HIFU and the NanoKnife and a role for proton therapy and I am not opposed to surveillance, robotic, open prostatectomy, external beam or seeds. I like them all………..
My point is this….the treatment a patient chooses often times has to do with the type of person they are and their financial resources. Having extra cash complicates things because you begin to think….”I can do anything and I can go anywhere to have it done.” So when a patient of mine scheduled an office visit in Miami with a urologist after I diagnosed his prostate cancer, then flew to the Bahama’s to have HIFU and came home with a suprapubic catheter in and had to wear it for five days, and then called me and told me that the suprapubic catheter was a “new way” to have a catheter and asked what would happen if there was a problem with the catheter and he was in Atlanta and his doctor was in Miami……..I thought of Charlie Sheen.
So what would ole Charlie do? He’d have Proton Radiation and he’d do it in California.
What do you think?
3 Replies to “what would charlie sheen do if he were diagnosed with prostate cancer?”
Charlie Sheen? A mid forties, otherwise healthy man with unlimited resources and another fun-filled lifetime ahead of him if he stays healthy? It seems like a no brainer to me: I think he would opt to have a nerve sparing RP — as long as there was no evidence of tumor spread and he was a good surgical candidate. This would be most especially true if his biopsy showed low volume low grade disease. I think he would be smart enough to realize (and his doctors should not let him forget) that he is is exactly the kind of person for whom the worst side effects — incontinence and ed — would eventually prove to be transient, and for whom a permanent cure would really allow another lifetime to be enjoyed, not crippled or shortened by further radiation, hormone or other treatments that might be needed if the proton therapy didn’t work the first time.
So, c’mon Dr. McHugh, wouldn’t you want Sheen to have the surgery if he was your patient? I’m thinking you would, and I am really wondering how much effort you would expend to keep him from choosing another modality? Yes, I understand that you want your informed patients to make up their own minds, but I think you must at least agree that each patient dearly values your opinion and, in fact, wants you to vigorously direct them toward what you, the EXPERT, feels is the best decision for them. Right?
Thanks for this great blog,
well well…..disagree with the first paragraph and detect a bit of sarcasm in the second.
charlie probably should have a RP but my point is that his personality won’t allow it….
i am an expert on prostate cancer but that is irrelevant…as my mother said…” you can lead a horse to water but you can’t make it drink….you can send a boy to college but you can’t make him think”
if you have been with an adolescent and telling them something important ” a life lesson” and you detect those ” far away eyes ” then you know what a urologist feels like with some patients when he or she begins outline treatment options. because a slice will listen to you but a hook won’t listen to a damn thing you say…. i never vigorously direct anyone particularly when i sense in the patient (and it’s easy to discern) their mind has been made up i.e. “the die has been cast.”
my next project for a book is to have my wife draw me caricatures of about 10 types of patients (that i have repeatedly seen over the years) and then show how the personality and bias of a patient will determine what treatment they choose, i.e. the CEO type will most commonly choose surgery, the internet type researcher will do what’s trendy, the farmer from the mountains will ask the doctor “what would you recommend?” etc.
so back to charlie?…. he can’t handle the truth…. by that i mean his fear of leaking urine and bieng impotent will far out weigh his concerns regarding cure and he will opt for the trendy treatment with the least down time and least potential for a dramatic change in lifestyle…..
but…..that is just my opinion……as i have said in my book about patients and their decision making….two things….. one… i don’t have a dog in this fight and two…it is your money you are gambling with… not mine. jack i apprec your comments and stopping in from time to time. the content of your comment will be helpful to someone and that is why you should keep em coming….
No, no sarcasm was meant by my remarks. You are the certified expert in this field, not to mention the fact that you have personally been through the awful bx/ surgery travail, which gives you an even added dimension of expertise. My point was to simply say that when a patient has confidence in someone such as yourself and is sitting there with you face to face, your opinion and bias in the matter at hand should be very heavily weighed in that patient’s decision making process. And, even if your patient ultimately decides on a course contrary to your first and best advice, he should at least leave your office with a clear idea of what you think is the best course from a medical perspective. Naturally, the life-style issues (and costs) should be left to the patient and his family to factor in before the final decision is made. But I do think the patient should leave your office very clearly understanding what you see as the most prudent medical/surgical course and give your thoughts top billing. So, as I suspected, you would tell Charlie Sheen that, in his shoes, you would have surgery surgery, but, of course, you would then let him do whatever he wanted.
Unfortunately, a side note to this issue is that there are unscrupulous doctors who will forget their oath when they see the chance for a fat fee. But that is another topic for discussion and should not make it appear in any way that an ordinary “internet educated” patient is ever more qualified than an experienced doctor to evaluate all the parameters and ultimately decide what the best medical treatment is.