“The Decision”- Table of Contents


Introduction – Now you know and the process begins   1

An arrow in your quiver.

Preface – So you have your own disease.

Part One – The basics                                                        9

Prostate cancer and the male – The perfect storm.

The PSA, rectal exam, and biopsy report – The “big three” are the essence of prostate cancer and define the aggressiveness of the disease. An understanding of each is imperative to “The Decision.”

The anatomy of the prostate – Water and nerves.

Treatment options – Usually, but not always, a major inconvenience.

Part Two – ‘Who are you?’ and why it matters               39 

General health, age, and years at risk – What’s best for the cancer may not be best for you.

Your PSA, rectal exam, and biopsy report – Understanding the specifics of your disease is key to making the right decision.

Bias – Do you have a dog in this fight?

Cure-driven – Most aggressive treatment is your priority.

Risk-driven – Least chance of side effects is your priority.

Lifestyle-driven – Ease of treatment is your priority.

Internet/family/friends – Apples to apples/Prostates to prostates.

Misconceptions and half-truths – Don’t let “a little knowledge” get you.

McHugh Decision Worksheet – Have you learned enough about yourself and your prostate cancer to answer these questions intelligently?

Part Three – Putting it all together – Methods for making “the decision”                                                                  111

Getting your priorities straight – Paper covers rock.

You’ve got good health and all options are open to you – Evaluating your underlying health is an important part of the decision process.

Evaluating the negatives – Picking your poison.

Best case/worse case scenarios – Evaluating the potential outcome of your decision from different perspectives may be of help to you.

How I made my decision – It’s not about doing what I did; it’s about making your decision the way I did.

How you should make yours – Now it’s your turn.

Decision Cheat Sheet – Tally up all the factors to see where you stand.

Part Four – You’ve decided                                            129 

You want it out – Open vs. Robotic.

You want radiation – External beam alone, seeds alone, or combination therapy.

You want to do something else – Just because it’s new doesn’t mean it’s better.

You want to do nothing – Surveillance therapy is always an option.

Representative case studies – How other’s decisions played out for them.

Part Five – The best laid plans oft go astray                157                

 The luck factor – I’d rather be lucky than good, and I’d rather have good luck than make the right decision.

Epilogue – Now that you know, tell others                    169

Shared joy-twice joy – Shared sorrow-half sorrow

Extras – Always give ‘em a little more than they paid for

Patients do the funniest things.

Did you know?

Prostate Stories – Only a urologist could write a story in which the main character is a prostate. 

Diaper Diaries – A screenplay

Did I treat you fairly?

I have good news. I have prostate cancer.

John, I heard you got cancer!

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