With the benefit of hindsight would you have chosen a different remedial option

Mel and Phenom,
Not my intention to be insulting. Just explaining how we really make decisions and it's not how we think we make decisions. There has been a lot of fascinating work done in the last decade on how the brain really makes decisions by using MRI and other brain wave measurements. In making a decision or reacting to a challenge to a decision or belief we already have the emotional part of the brain always reacts first, then later the rational lobes are activated in order to justify or rationalize the decision we came to. To us it appears that we are using rational thought to come to a decision, but to neural scientists the logical part of the brain is just used to justify the decision we already made using emotion or gut feel. We believe a decision first then use logic to justify that decision, but the logic is mostly flawed as we tend to search out information that supports our decisions and reject information that doesn't support it. Our beliefs, values, experiences and ideology determine the decision we will make and our rational brain is then used to justify that decision. It's simply how our brains work. This is why people looking at the exact same evidence can come out with totally different decisions. This is also why it is very difficult to change another's ideology or belief systems through reason or logic. I don't see anything insulting in this, as it is as natural as breathing.

I've always known how illogical my decision-making processes were. Otherwise, how could I have made so many bad ones! Having said that, I still find the answers to the original question interesting and possibly of value to others.

JOHN T:

Just another thought. I get involved a lot in political discussions with a few friends.

I would absolutely agree with you there. I know my friends and I do manage to cite articles, etc. that bolster our point of view while somehow ignoring articles/facts on the other side!

In short, we start with our proposition (ie: our emotional starting point) and then bolster it.

That is a LOT different than making a possible life/death medical decision.

Incidentally, my FIL died of PC about 15 years ago. He made no decisions. He trusted his doctors and never thought about questioning anything. That was how he was raised. Period. Maybe that is a case of emotions driving decisions...or is it logic, thinking that the doctor knows best?

Mel

Part of the difficulty in overcoming those emotional reactions with logic stems from the fact that, sooner or later, you have to evaluate any outcomes you have foreseen against the test of desirability and desire is an emotion. Logic can tell you what is likely to happen given a particular set of choices you are evaluating but it cannot, by itself, tell you whether that outcome is good or bad.

People with different outlooks -- different 'ideologies' as you put it -- are always accusing one another of being illogical, or ignoring the 'science' when often both are being quite logical given the value they put on different aspects of the anticipated results.

John T said...
Mel and Phenom,
Not my intention to be insulting. Just explaining how we really make decisions and it's not how we think we make decisions. There has been a lot of fascinating work done in the last decade on how the brain really makes decisions by using MRI and other brain wave measurements. In making a decision or reacting to a challenge to a decision or belief we already have the emotional part of the brain always reacts first, then later the rational lobes are activated in order to justify or rationalize the decision we came to. To us it appears that we are using rational thought to come to a decision, but to neural scientists the logical part of the brain is just used to justify the decision we already made using emotion or gut feel. We believe a decision first then use logic to justify that decision, but the logic is mostly flawed as we tend to search out information that supports our decisions and reject information that doesn't support it. Our beliefs, values, experiences and ideology determine the decision we will make and our rational brain is then used to justify that decision. It's simply how our brains work. This is why people looking at the exact same evidence can come out with totally different decisions. This is also why it is very difficult to change another's ideology or belief systems through reason or logic. I don't see anything insulting in this, as it is as natural as breathing.

Huh? The brain as nothing but fancy neurological circuity programmed to elicit a response?  Insulting to our humanity, indeed. Pascal, Dostoevsky, Kierkegaard, Chesterton and Pope Francis all say you're wrong. 

All I can say is….if the cancer does come back after seed implants and external radiation plus one year of lupron….think very carefully about not having salvage surgery….Pete had salvage surgery at sloan kettering after his psa began rising four years after his initial treatment. The salvage surgery was the beginning of seven years of incontinence, fistula twice, surgeries for those, artificial sphincter put in…and then more surgery to fix that…I have even forgotten the other surgery for his hip replacement and also carpal tunnel on both hands..possibly from losing bone from lupron..Also blood clots in both legs..hospitalized…..Now, tomorrow, a colonoscopy because the radiation that he had ten years ago has possible eroded another fistula or tumor….On top of that his psa has risen from 10 to 15.5 in three weeks.

He always says…if you have the surgery first, then you can have radiation if the cancer comes back..but having surgery after radiation is very difficult. The healing often does not go well, even with a very experienced surgeon.

I have forgotten the signature that I originally had..but it had all of the information. Di

PSA 60 said...
FWIW, it seems that most (all?) PC diagnoses are speculative in the first place. Even a clean RP doesn't guarantee that no PC remains. Secondly, most (all?) doctors prescribe treatment based on arbitrary classifications in statistical studies. Finally, even these studies merely result in derivative probability tables.

In others words, you are expected to make an informed decision about treatment without knowing exactly what you've got, how bad it is, and whether it will be life threatening, LOL.

good point. what I would really like to know is which group is more prone to have regrets: guys who are "cured" or guys whose treatment failed and are now fighting a systemic disease.

my gut tells me the former group but that just could be because of the dialog about PSA testing and overtreatment that has plagued the board lately.

ed

John:

You said:

>>>>>>>>>>

I would respond by saying there is something in your belief system that said getting the best doctors would improve your chances of survival. There are hundreds of thousands of others that go with their original doctor like your FIL did even though specialists were readily available with a little research and effort.

>>>>>>>>>>>>>>>>

But is this a belief based on a logical deduction, or mere emotion?

I say I used logic that said the best doctors should give me the best chance at good results. Or is this just some BLIND BELIEF. Someone said that you has the wherewithall to travel and seek out the best care. Was that just based on belief/emotion? Perhaps. One gets to splitting hairs, but if you explain EVERYTHING as being the results of emotions/beliefs than you probably truly explain NOTHING.

(This leads into religion, which I will now avoid! <g>)

Mel

Well, tomorrow will tell the story for us, …although, what we have learned over the years of this adventure,
is that..there never is really an answer immediately…there are always more tests, more waiting, more
specialists, more appointments…but there is always hope: Hope; An Owner's Manual

Look, you might as well know, this thing
is going to take endless repair: rubber bands,
crazy glue, tapioca, the square of the hypotenuse.
Nineteenth century novels. Heartstrings, sunrise:
all of these are useful. Also, feathers.


Merry Christmas to all you guys that are going through this. I hope you all have someone
that you can talk to, and also talk to your God….That helps most of all…to me anyway. Di

John….you wear me out….good night…and Merry Christmas! love. di

Divo -- obviously the doctors thought the PC was still local in your case. but why? My doctors told me if my disease were local seeds and IGRT would eradicate it. they told me up front that salvage surgery was not an option.

ed

JohnT, thats quite a religion you got there my friend. If not in letter, then definitely in spirit. Somewhat Rube Goldbergish for me, but if the puzzle is solved, time for a new puzzle……. I kinda think whatever we put our faith in, well I think we get exactly that. If we could discuss religion, I'd be interested in what that is in your case. Its a rhetorical question, cause we really shouldn't discuss religeon. Possibly you could discuss your theories, be cause it" isn't "religion. But there is no way I could discuss mine. Doesn't seem fair really. But in a strange way, that reality, actually bolsters mine. I use the word religion as cover for all theories , philosophies , and well religion. You know , that which we put our faith in. If you need not faith, thats impossible. You need faith to hold anything as a principal, even a "fact" Mods please do not delete my post without deleting JohnT's. But If you do , i can handle for again it will bolster mine, as set forth above. This really is just good conversation from one creat ure to another. Its not like we can talk about a creator with any logic. I mean how could we, if we are just creat ures. Ps I just picked up on this thread, so good conversation between many creatures. But not the one from the lagoon movies of the 50's. Wasn't that the the actor from the Kit Carson tv show in that.?? Id let this thread ride, its behaving better than most allowed subjects. Heck dialogue is dialogue, subject to breakdown on any subject.. there will be a day sooner than later when silly compartmentalizing, like we have in this paradigm, will seem as silly as flat earthers and the earth as the center of the universe.