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!
Prostate Diaries 