Good summary!

From my slightly different view, my doctor’s responsibility was to successfully treat my disease. Prostate cancer being one of self-advocacy and shared decision-making, it was my responsibility to bring to the table my goals, my priorities, and my (informed) opinions as to whether the treatment path they were recommending was in-line with that.

There were at least a half-dozen decision points where we weren’t in agreement on the treatment path. When their argument was stronger than mine, we went with their recommendation; when mine was stronger than theirs, we went with my recommendation.

I appreciated them being up-front with me by putting all their “treatment” cards on the table. That allowed me to put all my “goals and priorities” and other cards on the table, analyze the situation, and determine if, when, and how we should proceed with my treatments.

Each person is different. It’s my nature to be assertive (without being overbearing). Being a retired computer scientist, it’s also my nature to be analytical and methodical (sometimes to a fault).

As for your radiation oncologist’s statement to “hit this cancer so hard that it will never come back,” I recall a quote (paraphrased) in Shakespeare’s King Henry 4th, Part 1 - “Discretion is the better part of valor.” (Caution is preferable to rash bravery.)

Your radiation and ADT dosages should simply have been in line with your diagnosis. There should have been no need to argue up or argue down.
> what was your diagnosis (PSA, Gleason, etc.);
> what type and how much radiation did you get?
> was 18 months of hormone therapy the appropriate amount? (Undertreatment can be just as problematic as overtreatment.)

The radiation proctitis is a similar issue. We spent much time (many months) discussing how we would minimize the risk of radiation-induced adverse side-effects. As a result, I only had 1 day of radiation-induced adversed side-effects during treatment (something that neither of us foresaw); we treated it immediately and then continued on.

We also took early steps to minimize the adverse side-effects of the hormone therapy (Eligard). We tracked my testosterone level closely, and once it began returning, the few hormone therapy side-effects I did experience subsided.

As for dying from the disease (i.e., “to live seven more years without dying from prostate cancer”) —> Of all cancers that a man might get, prostate cancer has one of the lowest mortality rates. Dying from this disease has never seriously crossed my mind. (Here I am now 14+ years later; life goes on.)

Hopefully others will benefit from your lessons learned. To add to those:
> start PSA testing early (~45y/o) and annually;
> if diagnosed with prostate cancer, don’t panic; relax, breathe, get informed.

Then they’ll have the mindset and information to choose the right Center, treatment, specialists, etc.