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Protocol over person -The Quiet Tyranny of Standardized Care
Prostate Cancer | Last Active: Apr 7 7:18am | Replies (27)Comment receiving replies
You make some good points.
My husband has significant cardiac risks which were most likely made worse by the first 15 months of treatment for Gleason 9 prostate cancer . His PSA was 46.6 at diagnosis . Now he is facing Open Heart Surgery while still on ADT… and hard to get well considered advice about whether to stay on ADT or how long to be off of it before / after surgery..I don’t think there is enough research out there .
We may need to make a decision on our own .
Replies to "You make some good points. My husband has significant cardiac risks which were most likely made..."
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That's really rough. I'm so sorry.
Co-morbidities like heart disease complicate cancer treatment, and the more of them there are, the less likely that there's a big body of reasearch covering precisely the patient's situation.
It that case, what does an oncology team do? The safe course is to undertreat the cancer and let it take its course, because they're unlikely to be sued for that. Taking more drastic action to try to extend the patient's life is risky, both for the patient and (litigation-wise) for the medical team, but can have a big payoff if it works out.
That's why it's so important to have a conversation about risk tolerance up front. The onco team should initiate it, but if they don't, you can. I told my onco team in 2021 that I wanted to fight (stage 4, age mid 50s) and was willing to take chances and put up with harsh side effects. That made them more willing to take chances, too, since my wishes were clear.