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Informed Decision Making

Is this rise in the PSA significant? Do I have prostate cancer or not? How can I know what to do?

The most important question that will have to be answered is: "Is the tumor contained within the prostatic capsule or not?"

The correct answer here will determine whether or not you will be a good candidate for surgery or other invasive technique. Many studies show that the primary therapy fails in a high percentage of cases because extracapsular penetration, or migration to the lymph nodes, had already occurred prior to the procedure.

With the trend towards "Informed Decision-Making", the patient is expected to assume much more of the burden of deciding which treatment therapy to choose. You must gain all of the information needed and develop a strong partnership with your medical team to be able to make the right choice for your particular situation. I cannot emphasize enough the importance of having a family member or close friend being with you at all appointments to insure that you get the information you need and that the doctors hear the concerns you want to get across.

You must also be aware that every doctor is a product of their training and experience; urologists are surgeons, thus they look for surgical solutions for the therapy first – and the same goes for radiation oncologists, etc. You should look to have a 2nd, 3rd or 4th opinion from different perspectives (one should definitely be with a medical oncologist) and then choose the one that will give the best hope for a cure, or control, and also insure the best possible quality of life for you and your family afterwards. You also need to be certain that the doctor sees more than just an "organ" and views you as a whole person with certain lifestyles and expectations.

There are significantly different treatment protocols between breast and prostate cancer despite there being a great deal of genetic similarity. Many factors need to be taken into consideration in deciding which option you should choose. This video with Dr. Cristina Gutierrez, a radiation oncologist, provides commentary on helping to make your choice. - the online leader in providing cancer second opinions, empowering you and your local physician, to make the right choice for the appropriate treatment and desired quality of life. - (9/05/2012)

Lastly, don't underestimate the importance of the nurse in this equation. She, or he, will have had extensive experience in all aspects of dealing with cancer patients and can often provide points of information that you neglected to get from the doctor. They can guide you as to what to expect pre- and post- treatment and will always be there to give you the emotional support that is often needed as you go through a diagnostic and therapeutic process that can strip you of your dignity and self-image.

The term "health disparities" is often applied to certain ethnic and racial social groups, it describes the increased presence and severity of certain diseases, poorer health outcomes, and greater difficulty in obtaining healthcare services for these races and ethnicities. When systemic barriers to good health are avoidable yet still remain, they are often referred to as "health inequities."

On April 9 - 11, 2019 The Prostate Net in partnership with Vall d´Hebron Institute of Oncology in Spain developed a Symposium to Redefine Disparity with scientists and clinicians from the U.S., Europe and Africa to lay a foundation for on-going study of how research on the subject should be done.

Caucus: New Jersey with Steve Adubato - Prostate Health and Patient Navigation - Informed Choices

Additional Information Resources

Vietnam / Agent Orange - The Veterans Administration has determined that many diseases and medical conditions, including prostate cancer, may be related to service in the Vietnam-era theatre of war. Benefits, including medical treatment, disability allowances, etc. may be provided to those in need; further details can be seen at: or

Medicare.Gov - navigating all of the new Medicare regulations can be difficult; some assistance can be found at this site or through your local State Health Insurance Program (SHIP) office that can be found by calling 1.800.633.4227 or at

AARP Healthguide - provides access to specific information on many diseases, latest developments in conventional and alternative treatments, information on medications, Medicare questions and information on clinical trials.

Cancer.Gov - The site of the National Cancer Institute, which provides in-depth information on the disease, prevention, testing, treatment, clinical trials, etc.

Medline Plus - maintained by the National Library of Medicine; comprehensive information on health conditions and drugs; also provides a directory of doctors and hospitals. Available also in Spanish.

National Comprehensive Cancer Network - significant resource on all cancers, decision tree analysis for treatment, specific patient guidelines as well as patient referral service to hospitals and physicians.

Oncolink - excellent comprehensive database on all cancers provided by the University of Pennsylvania. - a site produced by the Patient Information Program of the American Society of Clinical Oncology (ASCO) providing comprehensive information on 85 types of cancer. - provides full range of information on all urologic diseases and conditions.

Agency for Health Care Research and Quality - AHRQ maintains an archive of articles on major research findings and provides tips on choosing quality health care; also available in Spanish.

Health Hoaxes and Rumors - site provided by the Centers for Disease Control and Prevention to counter the increasing number of false, health-related rumors

Intercultural Cancer Council - fact sheet detailing impact on minority and medically underserved populations

National Library of Medicine - database of published articles provided by National Institute of health including access to Medline publications.

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