@jonesfit65

You are not alone in what you are experiencing....https://www.urotoday.com/index.php

With the plethora of choices brought by advances in imaging and treatment through medical research comes the possibility of "paralysis by analysis."

The NCN and AUA guidelines offer a starting point for discussions with our medical team. They are the science based, the clinical trials, peer reviewed...

However, it is that rigorous scientific process which also may hinder decision making. They may be "outdated" given the pace of change. They are population based so your husband's clinical data not fit exactly to the guidelines.

There are other valid web based resources, PCRI, PCF, the NCCN Centers of Excellence whose web sites are full with treatment related information.

My experience is there is no single "right" decision. There are "good " decisions.

Once I make mine in concert with my medical team I don't look back and ask "was that the "right one!?"

I look to the present, is it working?

Depending on one's age, other health factors and consequent life expectancy it may help to adjust the window of expectations for treatment outcomes. I ask myself, will this work for the next 3-5 years? I am not concerned about the 10-15 year outcome. Why, well, overall survival is hard to measure because of time. Also, in that 10-15 year window, too much changes to compare the original treatment with new ones brought about by medical research.

My triplet therapy decision went against the guidelines but brought darn near five years off treatment. Same with my doublet therapy, at 20 months now, next labs in January.

Don't be hesitant to fire someone from one's medical team if they are not supportive of shared decision making, are not active listeners, closed to new ideas that challenge existing paradigms...,albeit with solid scientific research supporting the new ideas.

Kevin