Sunday, October 19, 2014

A Pictorial Explanation Why Men Choose Unnecessarily Aggressive Treatments for Prostate Cancer

Here's a very easy and visual way to understand why too many men are choosing unnecessarily aggressive treatments for prostate cancer. When your Doctor is discussing your prostate cancer his image of your cancer looks something like this:



The picture above also represents the image your Doctor thinks you have of your cancer. In my case, perhaps in yours, his assumption was highly inaccurate. Unfortunately, no one takes to understand each others pictures. Here's something like the image I had in my mind as my Urologist told me about my prostate cancer.

 I imagined millions of these guys chopping away at the lining of my prostate 24/7 with the mindless goal of creating a microscopic hole in my prostate. This would allow legions of these cells to migrate into various parts of my body. Once they accomplished their easily achievable goal of creating a microscopic hole in the lining of my prostate, my fate was sealed. In the not too distant future I'd die of prostate cancer.

I spent way too many sleepless nights wondering each night if this would be the night the army of cancer cells in my prostate created the microscopic hole they needed in order to establish new headquarters throughout my body. We were at war, except I wasn't doing anything to defend myself, my body and my life, while my enemy was working 24/7 to kill me.

If that wasn't enough to generate overwhelming anxiety, I was flooded with the memories of everyone I ever knew who died from cancer. It was a very long list!  Some of those on the list died very quickly. Others suffered for many months as cancer ravaged their bodies.

By the time you're old enough to receive a diagnosis of prostate cancer, all of us have our own awful and frightening memories of those we knew and loved who died of cancer. These memories and experiences help shape our fear and our decision making process about how to treat our cancer.

The fear you feel combined with your past experiences with cancer motivates and compels you to make the decision to fight your cancer in the most most aggressive ways possible.

I believe men and their partners need to spend a minimum of  hour with a Health Care Specialist after they are given the news they have prostate cancer. We need help to separate  our fear and our past experiences with cancer. If you do not take the time to do this, you'll probably make a fear based treatment choice.

What's unique about prostate cancer is this: Your cancer could be aggressive, which means an aggressive treatment is appropriate. It could be a very slow growing cancer that would not effect you in any way for decades into the future. Read the previous sentence again. There is such a thing as a slow growing cancer that is NOT life threatening!

The worst thing you can do is to make the decision to go through an unnecessarily aggressive form of treatment based upon your fears about cancer. If you've been recently diagnosed with prostate cancer, take time to:

1, Process your past experiences with cancer. Deal with those fears before projecting them into your current situation. It's possible to have prostate cancer without needing to fear anything.

2, Learn more about the type of cancer you have and whether or not you dealing with a cancer that requires aggressive treatment. You may be one of those fortunate men diagnosed with prostate cancer who can go for decades with active surveillance.

So my best advice is this: Make your treatment decision based on your diagnosis rather than your fear about cancer,  If you are considering the robotic surgical option to treat PC or you'd like additional information about the emotional, relational, sexual and spiritual aspects of prostate cancer, check out my book by clicking HERE


Saturday, October 18, 2014

How Do You Want Cancer To Change You & Your Relationships?

A few years ago I met a man who had surgery to treat his prostate cancer. Fortunately for him his cancer was confined to his prostate. Unfortunately for his wife and family, he came out of surgery with a sense of entitlement. He was now a cancer survivor who came face to face with the reality that his time on earth was limited.  He decided he wanted to the time he had left to live in the selfish pursuit of pleasure. (selfish was his word, not mine) The first thing on his on his bucket list of things to do was to leave his wife and children. They were a responsibility and he was done with responsibilities.

Another man I knew with PC was suffering from ED following surgery. His wife was turned off by his need for penile injections. Rather than work out a solution, they stopped having sex. Not long afterward he found a girlfriend who was turned on by penile injections, So much so that she wanted to be the one to give him his injections. This man felt he'd met his soul mate.  He knew a divorce would disrupt this relationship with his children and grandchildren, so he decided he'd let his marriage decline, while he enjoyed his relationship with his girlfriend, children, and grandchildren.

Both men were cured of cancer. One abandoned his wife and children in the pursuit of selfish pleasure.  The other decided to become a liar and an adulterer. I suspect at some point in the future he'd get caught and/or end his marriage.  On a survey on  my Website I ask the question: How has surgery effected your relationship with your partner? Forty-eight percent say they grew closer.

I want to be in the 48% club! I want the people  who know me to say "Rick's grown kinder, more compassionate, more loving and generous. We've grown closer since his diagnosis."

This didn't automatically happen because I wished it to be true. Coping with cancer and the aftermath of treatment is a very difficult journey. At times my marriage was stressed to the max. There were times when I was so depressed that I withdrew from everyone I loved.

Coping with cancer is a journey. In my next blog I'll share what I believe you need in order to become a member of the 48% club. My wife & I wrote our book: I Left My Prostate In San Francisco Where's Yours? Coping With The Emotional, Relational. Sexual & Spiritual Aspects of Prostate Cancer  in order to help couples make it into the 48% club.




Monday, October 13, 2014

What Doctor's Won't Tell You About Cancer


Approximately 40.4 percent of men and women will be diagnosed with all cancer sites at some point during their lifetime, based on 2009-2011 data.  In a study conducted by the National Cancer Institute, 476 people who received a diagnosis of cancer participated in a survey. Some of those findings suggest the way we receive this devastating news is in need of serious repair.

The authors reported that a little over half the patients were told their diagnoses in their doctor's office, 18% over the phone, and 28% in the hospital. 44% of the conversations lasted less than 10 minutes, and 53% lasted more than 10 minutes. In about 31% of the conversations, no treatment plan was discussed. It is no surprise to anyone that patients were more satisfied with the experience-if you can say that you can be satisfied with hearing you have cancer--with in person discussions rather than by telephone, with longer time and with an explanation of treatment options.

  • 39% of the patients were alone when told of their cancer diagnosis.
  • 8% of the patients had a less than 1 minute conversation about their diagnoses. 36% said the conversation lasted between 1 and 10 minutes.
  • 15% of the patients lost trust in their physician as a result of the conversation, based on poor communication and general dissatisfaction.
These statistics show how broken the medical system is with regard to how men and woman receive the news they have cancer. The fact that 39% received the news when they were alone is inexcusable. Also alarming is the fact 15% of  those in the study lost trust in their physicians as a result of the way in which the news as provided.  Based on the responses  I've received so far from men with PC, I believe this number may be lower for men diagnosed with prostate cancer. 

That said, what seems to be missing for the overwhelming people who receive a diagnosis of cancer is this important fact:
Coping with cancer has both a medical component and an emotional component. After I received the diagnosis of prostate cancer, fear and anxiety became my constant companions as well as many sleepless nights.  No one ever discussed the emotional component of coping with the diagnosis of prostate cancer. No one ever suggested I seek other men further along in the journey to help me in this process of coping with prostate cancer. I felt isolated and alone. 

That's the reason my wife and I wrote our book, We wanted to offer men and couples the information and help they didn't receive at the time they were given the news. 
Check it out on Amazon.com:
I Left My Prostate In San Francisco-Where's Yours?
Coping With The Emotional, Relational, Sexual & Spiritual Aspects of Prostate Cancer.

The book provides you the information you and your partner need to cope with prostate cancer. Don't take my word for it,  Here's what a reader said about our book.

The Redner's have combined their efforts to provide a very thorough and insightful overview of a broad spectrum of the emotional, physical, and spiritual experiences that make up the beginnings of the "cancer journey" as viewed from both the patient's and caregiver's standpoints. (I wish this had been available to me when I received my diagnosis and began treatments in 2009!) Many of the subjects they write about were never discussed with us by my doctors - and should have been! And, much of the advice they offer regarding their experiences I've not seen or read about in any other source

The majority of people who receive a diagnosis of cancer find it to be a traumatic and life changing event. My wife and I offer the information and support regarding the emotional, relational, sexual and spiritual  aspects of prostate cancer, If you are coping with cancer of any kind, it's worth checking out this book.



Saturday, October 11, 2014

Receiving The News You Have Cancer

I came across a study from the National Cancer Institute about the ways in which the news was given to those with cancer. Here's the results:
 437 patients surveyed had been referred for treatment. The researchers asked them how they learned of their diagnosis, what the doctors told them at the time they received the news, where they were located when they had the conversation, and how long the conversation lasted

The authors reported that a little over half the patients were told their diagnoses in their doctor's office, 18% over the phone, and 28% in the hospital. 44% of the conversations lasted less than 10 minutes, and 53% lasted more than 10 minutes. In about 31% of the conversations, no treatment plan was discussed. It is no surprise to anyone that patients were more satisfied with the experience-if you can say that you can be satisfied with hearing you have cancer--with in person discussions rather than by telephone, with longer time and with an explanation of treatment options.

I must be an odd ball. I did NOT want to receive the news in my Doctor's office. I asked him to call me at home. Since I was 100% certain I'd be receiving the news I had prostate cancer, I wanted receive that news in the comfort and safety of my own home.

 Additionally, I didn't want to get behind the wheel and drive knowing I'd be shell shocked.  The phone call I received was 10 minutes, but the questions I had at the time were answered. At the time I was satisfied with the way I received the news. Looking back I realize the news left my wife and I alone with our terror.

When someone receives potentially life threatening and/or the catastrophic news they have cancer, they should have access to a Medical Social Worker or Nurse who can help them process the news from a medical and an emotional standpoint.

Any man/couple who receives the diagnosis of prostate cancer should receive a list resources available on-line and face to face which will enable them to reach out to others further along in the journey of coping with prostate cancer.

If you were diagnosed with cancer, how were your told and were you satisfied with the process.






Monday, October 6, 2014

Doctor, YOU'RE FIRED!

I’ll never forget the day I was fired as a Dad by my three year old son. He and I enjoyed watching the Jetsons. Almost every week Mr Spacely would say to George Jetson “George Jetson, you’re fired!”

One day it was taking me longer than usual to strap my son into his car seat. Unexpectedly my son started to imitate the tone of Mr Spacely and he then uttered these unforgettable words: "Daaaddy you’re fired!” I've been a parent now for more than three decades. Thankfully, it was the first and last time I was ever fired as a Dad. I still joke with Andy about the day he fired me. He still insists he made a right decision because it took me too long to strap him in.

This week I learned that not knowing when to fire someone could cost you your life.  I just heard from a fifty-year-old man who a decade ago (when he was 40)  asked his Doctor to perform a digital rectal exam and to take a PSA. His Doctor told him both tests were unnecessary until he turned fifty.
This man placed his trust in his Doctor's judgement.

Some Doctors believe that men who find out they have prostate cancer seriously harm themselves by choosing an unnecessarily aggressive treatment option. They believe it's better to keep men in the dark so they won't make a foolish treatment decision which will cause them more harm than the prostate cancer ever could.

I grew up in an era where Doctors were right below God in status and importance. If a Doctor said something, it had to be true. The very idea of questioning a Doctor’s judgement was unthinkable. Unfortunately, some Doctors still believe in this myth, some patients still believe this as well.

The reality is Doctors are fallible, in other words, they make mistakes. If you as a patient ask for a test, which is reasonable to perform, and your Doctor refuses, fire your Doctor. Find another who believes they work for you.

This story does not have a happily ever after ending. This man trusted his Doctor for a decade. He had his first digital rectal exam and PSA when he turned 50. His PSA was just shy of 40.  Subsequent testing would show his cancer had spread beyond his prostate. The opportunity for a cure had past. Now he wonders how many years his life will be cut short as a result of prostate cancer.

Sometimes your life depends upon whether or not you can look your Doctor in the eyes and say “Doctor YOU’RE FIRED. For those men who aren't temperamentally able to tell their Doctor they are fired, don’t say a word. Simply find a Doctor who believes they work for you.


Sunday, September 28, 2014

Why Men Lie to their Doctors


I vividly remember the first time I lied to a Doctor.  Approximately 43 years ago, I was heading home from work. A woman who wasn’t paying attention crossed into my lane. I was traveling at approximately 45 miles per/hour. I was so close to her when crossed into my lane,  I had no time to step on my break. I crashed into her head on at full speed.

Cars didn't have seat belts in those days.  I had no clue how long it took for an ambulance to arrive because I was unconscious. When the paramedic arrived, I had idea what had happened or where I was. I was glad he arrived because I knew I needed help, but didn't know why.
Once I was in the hospital I’d learned that I was found hanging out of the ride side of the car. The side of my face hit the right side of the car with enough force to break my zygomatic arch  (my cheek bone) The ER Doc told me I’d need plastic surgery to repair it.

During my ER exam I was asked repeatedly if I lost consciousness. I was a very frightened teenager at the time. I knew I was facing surgery and I no idea what else they’d do to me if I told them the truth, so I lied. I told them I was awake the whole time until the ambulance arrived. The truth was I had no idea whether I'd been hanging out of my car for minutes or hours. I didn't even know I'd been involved in a car accident until they told me.

I paid a very high price for lying to my Doctors. When I was released from the hospital I went back to college. I had no memory of the courses I was enrolled in. I had to go to the Administrative office to get a copy of my schedule. I had no memory of what I'd been taught in any of my classes. I had to go back to page one in every one of my text books. I also discovered I didn't know my way around campus. I was totally lost. It was as though I'd never been to the campus. It was necessary for me to ask directions to get to every one of my classes. I frequently got lost because I had no memory of the layout of the campus. It was as though I'd never been there before.

 I never told anyone about my loss of memory. Decades later, when I was a Medical Social Worker in a Head Injury Unit,  I came to the understanding and realization that many of the problems I'd experienced immediately following the accident and for decades afterward was a direct result of the traumatic head injury I suffered as a teenager. I never received any treatment for my traumatic head injury because I lied to my Doctors. That was the first time I lied to my Doctors, Unfortunately, it wasn't the last.

Men frequently lie during their medical exams. They routinely lie about how much they drink, smoke, use drugs and exercise. Another way men lie is by omission. They will frequently “forget” to tell their Doctor about troubling symptoms. Men are much less likely to visit their Doctor’s than women. Based on my own experiences,I believe men want to tough it out.

Currently I’m experiencing moderate pain in one knee, and sometimes severe pain in the other. I have no plans to make an appointment with my Doctor. I live in a two-story house. When I’m unable to get up the stairs, that’s when I'll call for an appointment. Is my behavior logical or rational? No it isn't. Am I sticking with this plan? Yes I am.

Men’s resistance to seeing a Doctor can cost men their lives. Two stories come to my mind. One involves a man who sharpens my knives for my restaurants. One day he was experiencing chest pain. His wife told him he needed to go to an ER immediately. He told her he wasn't leaving the store. Fortunately for him, his wife immediately called 911. By making that call, she saved his life. He’d just had a moderately severe heart attack. He would have died in his store if his wife wasn't there to call an ambulance.

The other man wasn't as fortunate. My wife was attending a wedding. Her best friend’s father experienced chest pains. He told no one. Instead, he went to his car where he could be alone with his pain.  That's where they found him, dead in his car.

In both of these situations the men involved refused to seek out medical help. The only reason one of these men survived was that his wife was with him at the time of his medical emergency. She didn't give him the option to refuse medical attention.

Prostate cancer is a different type of disease. It can be silent and without symptoms for decades. Once symptoms appear, prostate cancer is usually outside of the prostate making a cure impossible. There’s only one way to get a jump on this disease and that’s through regular digital exams and PSA testing. We are approaching end of September which is Prostate Cancer Awareness Month.  Do yourself and those you love a favor. Suffer the humiliation and discomfort and get both a digital exam and a PSA.





Thursday, September 4, 2014

The Road To Hell Is Paved With Good Intentions

Whether you have a faith in God or not, the Bible is one of the best books even written to gain wisdom for living.  Here's a  verse which I believe should be applied to those who are for and against prostate cancer screening.

Matt 7:16-18
You will know them by their fruits. Do men gather grapes from thornbushes or figs from thistles?  Even so, every good tree bears good fruit, but a bad tree bears bad fruit.

 In America 98% of graduating medical students swear to some form of the Hippocratic Oath. In this oath a Doctor swears "that s/he will do what's best for the patient rather than whats best for the physician."

Here's the problem for men. The following organizations believe men who are diagnosed with prostate cancer hurt themselves with unnecessary and aggressive treatment causing a life-time of harm. Here's the list of organizations who want to protect men by keeping them in the dark about prostate cancer:
US Preventative Task Force
The American Urological Association recommends men wait until they are 55 before  prostate cancer screening.
The The American Academy of Family Physicans came out against screening.

Let's get the fruit of these recommendations. In the past week I've heard from men and widows who were effected in devastating ways by prostate cancer while men were in their 30's. The devastation came in from two directions. Either men died quickly or men suffered with advanced PC for years because they were considered too young to be screened for PC.

So the question for this month, National Prostate Cancer Awareness Month is: Does Prostate Screening Save Lives?
Some say No
Others Say Yes

If you live by: "When in doubt, take the easy way out"- Then you'll avoid screening and agree with those who say: Don't bother.

As a man who was dx with PC at age 58 I'm outraged that organizations have come out against prostate cancer screening in order to protect men from themselves. Here's where the road to hell is paved with good intentions and the need to be a fruit inspector comes into play. I've recently met some PC widows whose husbands would be alive today IF they were screened in their 30's.

To every healthy man who reads this, it's your life. Do you want to live until you see your children marry? Do you want to live to become a grandfather? Increase the odds of this happening. Get your PSA and prostate checked in your 30's. Unfortunately, most Doctors will tell you this is unnecessary. I say it is. Who are you going to believe? To those men who say I'll believe the guy or gal with the medical degree consider this:
Incidence of aggressive cancer in young men is on the rise

Do yourself and those who love you a favor. Get your prostate and PSA checked. The life you could save would be your own. If you know a man who hasn't had his prostate checked, share this blog with him. You may become his life saver.

If you've dx with PC and want more information about the Robotic Surgery check out my book:
I Left My Prostate In San Francisco-Where's Yours?
By Rick Redner MSW & my wife Brenda Redner RN