Are our doctors truthful?

of course he told you that while saying he could "get it all" with surgery, and you always have radiation as a back-up. not being truthful, in your case, is the way i'm leaning.

I believe that my Urologist was not truthful in manys, but I cannot say that he lied to me. He just "forgot" to tell me about some of the nuanced, but important, side-effects of surgery. He never promised a cure, but in retrospect I think he inflated my chances when he clearly knew better.

In contrast, my RO and MOs have been straight up.

Initially my URO was all about statistics...you only have a 25% chance of having cancer, you only have a 20% chance it got out, you only have a 2% chance of having aggressive cancer that will actually kill you...etc. Unfortunately, it took me a while to become educated and realize he was working on twenty year old protocols and was not the least up to date on recent research, studies, etc. He fired me a couple of months ago Telling me he couldn’t meet my expectations. Didn’t know about Stampede or Latitude studies and wanted to start “shots” alone. Considered my mention of Zytiga or Xtandi as experimental treatment and sent me packing. I so regret not challenging his ego sooner but don’t get do overs now. I had an RO that painted a rosie picture as well, when I knew my odds were like 30%-40% of having SRT work, but did it nonetheless. Now here we are, metastatic stage IV PCa, on Eligard, Zytiga, etc and with an MO who knows his stuff. It’s been quite a ride but wish I hadn’t accepted mediocre medical care when I should have sought the best available at the time. My bad...

fiddlecanoe said...
When I was first diagnosed with PCa, the urologist was pretty straightforward. It was a 4+7 biopsy. He was neither optimistic or pessimistic -- just very factual. It would have been ridiculous for him to be super-optimistic because I was going to go home and google everything and read about it on my own.

Fast forward a bit. I was visiting a local RO to discuss ART. I asked him what he thought the odds would be of curing the cancer. He said 20%!! That was depressing!! Then I went to a medical center in a nearby city and there the RO said it was more like a 50% probability of a cure. That may have been his way of saying that he had no idea, or maybe he agreed that it was 20% but thought it would be too depressing to say it.

50/50 = either it will or won't.

Doctors are caught between a rock and a hard place when it comes to being fully honest with a patient, especially when it comes to a life and death matter. Should they be fully honest? Yeah, I guess. The patient has a right to know what he or she is facing down the road. But the doc knows that a disease like prostate cancer, even in advanced stages, could take years to threaten survival. So a good number of medical professionals don't want to throw the patient into a deep depression and compound the problems. After all - they're in the business of healing.

I have locally advanced disease. I've been darn lucky since my PSA has remained low or undetectable (depending on which test you look at) coming up on 4 years. My PCP tells me that he's not at all worried about a recurrence. First off, of course he's not worried. It's not his cancer. Secondly, he wants to put my mind at ease. And I appreciate that because I know where he's coming from. But in my heart I know I'll always be at significant risk for recurrence. I've had to play psychological tricks on myself to abate the anxiety that goes along with it. So am I resentful that my doc is playing rosy word games with me? No, not at all. The man is using his best judgment. I'd likely do the same if I were in his position. He doesn't want to pile on more stress factor. Now, if I had 4 months to live I have no doubt he'd tell me to get my personal affairs in order. But why freak me out and tell me I have a 60% chance for a recurrence when all it's going to do is put me in a funk? What good does that do?

When it comes to honesty you have to analyze the situation. Sometimes it makes sense to lie. Even for doctors.

I agree.

My uro said it was organ contained and could likely be 'cured' with surgery. It wasn't. The RO said she had a "96.6%" cure rate. Guess I was in the 3.4% fail group. Everybody agreed that the 2 & 1/2 years of leuprolide chemotherapy + surgery + radiation would surely cure me. It didn't.

Now I get to be an 'oligometastatic stage 4" cancer patient. Everyone else involved has made a ton of money off the treatments though.

I'll side with those saying docs are generally honest. Problem is their nature is to guide the patient to reach a particular conclusion. A surgical oncologist isn't necessarily "lying" when he says RP is best course of action. It may be his honest opinion that surgery is best. That is why the advice I give anyone, new to this disease, is to talk to as many docs as possible and do a lot of research. Politely challenge doctors to explain "Why X treatment is best" in your particular case. There are differences in stage of disease progression for all of us and that should be the key part of determining best course of treatment.

mr bill said...
Having gone through surgery, radiation, chemo, and now HT for a little over two years, I asked the Physician Assistant for the Medical Oncologist I see. For the past two years I have visited with her every three months, and found her to be very knowledgeable and straight forward. A couple of months ago I asked her the loaded question, "how long do I have?" She took the time to explain their method of applying treatment time to expectancy of effectiveness. She asked "do you have a bucket list?" I replied, "yes I do." With raised eyebrows she replied "don't neglect it." Purest form of honesty I have experienced.

the average life expectancy of a man in the US is 76. but....when I was a kid it was 63.5. so I may be going before you

Those were the days for sure. We were bullet proof.
https://www.google.com/search?source=hp&ei=-sfaxczvbthh-gt2hztwcq&q=mary+hopkins+those+were+the+days&oq=mary+hopkins+&gs_l=psy-ab.1.2.0l10.1933.7206..10102...0.0..0.137.1598.0j13......0....1..gws-wiz.......0i131.9rde-97es4k#spf=1574619143329

If your wives asked you if you lust in your heart (w/o following through) for other women - and you do - what would you tell them?

Look at the unnecessary and avoidable problems it caused Jimmy Carter.

Truth is a great concept. Many great philosophers of our time made a nice living analyzing it but not necessarily living it.

But does absolute truth make sense in all situations, especially when it won't change outcomes?

Nah. It just gets you in trouble and may cause tremendous pain for others.

Discretion.

>>If your wives asked you if you lust in your heart (w/o following through) for other women - and you do - what would you tell them?<<


I would tell her I lust in my loins. she's not an idiot and I don't need a doctor to treat me like I am one.

Non judgmentalism. That’s all I have to say.

(“Just the facts Ma’am. Nothing but the facts”) 😊

(“And if you don’t know the facts, the truth will suffice”)


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Post Edited (island time) : 11/24/2019 1:49:27 PM (GMT-7)