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.

Rick Redner & his wife Brenda Redner authored two award winning books, both available on Amazon. They are: 

I Left My Prostate in San Francisco-Where’s Yours?

&

Everything You Never Wanted to Know About Erectile Dysfunction & Penile Implants

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.

Why Men Lie to their Doctors

I vividly remember the first time I lied to a Doctor.  Approximately fifty 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.

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

Prostate Cancer-Fatal or Harmless? That Is The Question!

Although this article is two years old, it’s more accurate today than the day it was written. Robotic Surgery has  rapidly became the treatment of choice for men with prostate cancer. In part, this is due to heavy marketing campaign of surgeons and treatment centers. While they tout the benefits of surgery I wonder how many men/ couples were told the results found in this study:

“Within two years of surgery, the researchers found that 81 percent of the men who underwent the procedure experienced erectile dysfunction, 17 percent had urinary incontinence with symptoms such as "dribbling" or having "no control over urine," and 12 percent reported bowel dysfunction. I wonder what would happen if those statistics were presented to men/couples prior to surgery. Would that influence the decision making process for men?

Here’s another finding I thought was disturbing:
With early stage prostate cancer surgery did not significantly reduce the men's risk of dying from the cancer or any cause, as compared with the observation approach. (Active Surveillance)

There’s no doubt too many men are choosing surgery in the early stages of prostate cancer. Unfortunately, for those men, surgery won’t make a difference in their survival rates. Instead of an extending their lives, these men will needlessly suffer permanent life altering consequences.

There's another reality men need to take into consideration. Prostate Cancer can be a deadly disease. According to the American Cancer Society,  prostate cancer is the second leading cause of cancer death in men. So Prostate Cancer is NOT a disease to be taken lightly.

 In order for men to make the right treatment decision it’s important to deal with your previous experiences with cancer. The odds are you’ve known one or more people who’ve died as a result of cancer. The word cancer is associated with vivid images of suffering and death. Those powerful images give rise to fear.

Making a fear-based decision about treating your prostate cancer will result in you choosing the most aggressive form of treatment available. For most men that’s surgery.

The most important thing for men to do is hold off on making a decision about treatment until you have all the facts about your specific cancer. If it’s aggressive, aggressive treatment is required. If it’s not aggressive, choosing active surveillance may be the appropriate treatment option. I can’t say this often enough, make your treatment choice based on your diagnosis rather than your fears.

If now or in the future someone you know is diagnosed with prostate cancer, I hope you'll share this blog with them.

For men who want to know more about impact that robotic surgery has on your sexuality and relationships consider reading the book my wife (Brenda Redner)  and I (Rick Redner)  wrote about our experiences.  Here’s the link to: I Left My Prostate in San Francisco-Where’s Yours?     You can also visit my website at:
Where is your prostate?
Here you'll find a lot of information about the surgical option.

Why Men Avoid Prostate Exams

The answer to the question of why  men avoid prostate exams isn't as simple as the obvious answer that no man in their right mind wants to feel a physician's finger go deeply into their rectum.  It's an uncomfortable and potentially embarrassing exam, but let's put that aside and look at other reasons.

Unfortunately,  men are less likely to seek out medical attention. According to The Center For Disease Control men are 80% LESS likely than a women to use a regular source of health care. It takes an illness to get the majority of men to visit a doctor and even then many men resist. Prostate cancer is a silent disease. By the time there are symptoms it's usually too late for a cure.

Thoughtful men who research the topic will find many powerful voices  stating that prostate exams will do more harm than good.The U.S. Preventative Task Force  and  the American Academy of Family Physicians came out against prostate cancer screening in men without symptoms. Even the American Urological Association came out against PSA screening in men under 40  and doesn't recommend screening between the ages of 40 and 54 for men at average risk. Visit Prostate Cancer Under 50 if you want to connect with a group of men whose lives were saved due to earlier than recommended prostate cancer screening.

It appears the medical profession wants to protect men from making bad decisions once they are given the news they have prostate cancer. According to the Mayo Clinic, somewhere between 17-50% of men who are diagnosed with prostate cancer over treat their cancer and end up suffering with a lifetime of symptoms such as the loss of urinary control or a lifetime of erectile dysfunction.

I don't understand how or why doctors would recommend that men be kept in the dark about a potentially fatal disease.  If men are making bad decisions after they are given the news they have prostate cancer, the right question to ask is: What can be done to help men make the best treatment decision based on their diagnosis rather than their fear of cancer?

Before men began to celebrate they can avoid a digital rectal exam and\or or a PSA test I believe men need to know there's been a significant jump in the number of YOUNG men dying of prostate cancer which means the Incidence of young men with aggressive prostate cancer is on the rise..

Here's  what needs to be done in order for men to do all they can so they won't die from prostate cancer. First, men need to overcome their resistance to avoid medical care when they are symptom free. Second, men need to cope with the discomfort, embarrassment, and/or  aversion to a digital rectal exam. Third, all of us lean toward  following advice you already agree with. So if you are against prostate exams you'll be glad to follow this advice:  Say Goodbye to Prostate Exams.

The only problem following that advice is that it's  possible  you could be one of those men who have an aggressive form of prostate cancer  early in your life. Therefore, skipping out on your prostate exam could be a fatal decision. That's why I believe all men should have their first PSA and prostate exam at age 30. If you are in a high risk group or have a history of prostate cancer in your family I suggest your first exam  and PSA  at age 20. I strongly prefer the adage "better safe than sorry" applies to prostate cancer screening. Here's the bottom line: Prostate Cancer Screening Saves Lives

If  you happen to be one of the 233,000 men who will receive a diagnosis of prostate cancer this year, use caution. Don't  panic and  rush into aggressive treatment. Take the time to find out whether or not your cancer is aggressive and whether you need aggressive treatment. For many men Active Surveillance is all the treatment you'll need.

Yearly Prostate  cancer screening saved my life. It could save yours.

If your cancer is aggressive and your considering surgery check out my award winning book:
I Left My Prostate in San Francisco-Where's Yours?

Keeping Men In Dark About Their Prostate Cancer

According to the American Cancer:

Other than skin cancer, prostate cancer is the most common cancer in American men. The American Cancer Society’s estimates for prostate cancer in the United States for 2014 are:

• About 233,000 new cases of prostate cancer will be diagnosed
• About 29,480 men will die of prostate cancer

About 1 man in 7 will be diagnosed with prostate cancer during his lifetime.

Prostate cancer occurs mainly in older men. About 6 cases in 10 are diagnosed in men aged 65 or older, and it is rare before age 40. The average age at the time of diagnosis is about 66.

Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer. About 1 man in 36 will die of prostate cancer.

The number of younger men diagnosed with aggressive cancer is increasing. Unfortunately  there is a new threat that's emerging for men with prostate cancer. This threat comes from an unexpected source.....the medical community. 

A recent study concludes that prostate cancer screening saves lives, but casts doubt on the benefits of early screening. The U.S  Preventative Task Force came out against prostate cancer screening.

Here's the problem: Too many men are choosing to threat their cancer aggressively and suffering from unnecessary and very unpleasant life long consequences as a result of their treatment choice. In order to protect men from making bad decisions, there is a growing number of medical professionals who believe keeping men in the dark and allowing men to die unnecessarily  from prostate cancer is the solution to the problem of over treatment. From my perspective this is insanity. 

Why are too many men choosing to over treat their cancer? There is a one word answer: FEAR. When I was diagnosed with prostate cancer powerful images of pain, suffering and death came to my mind. If that's how and when men are asked to make a treatment decision they will go for the most aggressive treatment available. That's no reason keep men in the dark and permit other men to die unnecessarily of a disease that could be treated. Yet that's exactly what many in the medical community are proposing.  

As a prostate cancer survivor, I believe the right thing to do is to help men manage their fears and misconceptions about cancer,]. This will empower men  to make best treatment decision based on facts and their diagnosis rather than their fears.  Why is this so difficult for the medical community to understand? Could it be there is widespread ignorance about the emotional aspects of receiving the diagnosis of cancer? 

 In an article I wrote for Alternative Medicine Magazine I propose a way to help men get past their fears in order to make the best treatment decision. This makes infinitely  more sense than keeping men in the dark and allowing others to die. If you are considering surgery as a treatment choice or experiencing difficulty adjusting to life without a prostate check out my book I Left My Prostate in San Francisco-Where's Yours?