Patients share how researching treatment options, consulting trusted specialists, and taking time to make informed decisions helped them choose the approach that best fit their individual diagnosis and priorities. They encourage patients to seek expert care, ask questions, trust providers who value shared decision-making, and feel confident in the treatment path they choose.

Brian McCloskey:

I started where probably everybody starts, which is Google. So just researching through Google, I knew that I needed to go to trusted sources and so I went to NCI. I can't remember if I went to Euro today, but a number of other publications that could help me gain an understanding of what this disease is, how to think about it, and how to find the right care.

I had a decision that I had to make very quickly, which was based upon my Gleason score, which came out from the biopsy, I knew that I needed to take some action. Active surveillance was possibly an option but really wasn't recommended. And so it really came down to, at the time, local therapy. Do I do surgery or do I do radiation? And as you can imagine as you're skipping through life, you're not thinking about, "I have to have surgery or radiation within the next two, three months." It just isn't something that's part of your plan.

So it took me a fair bit of work to determine which of those two primary options, there were a few others, but those two primary options I wanted to pursue, and I made the decision to have surgery and I had that three months after my diagnosis, or actually maybe even a little bit less than that. So I made a decision fairly quickly and my prostate cancer was contained within my prostate. I had negative margins, but apparently it had already metastasized even though it wasn't really visible on imaging. And so after I had a prostatectomy, my PSA did come down, but then it began to rise again fairly quickly.

And so that's when I learned that I had very aggressive prostate cancer, a Gleason 9, and that maybe there's one other line of therapy I could do that could have been curative, which was radiation. So I did 40 rounds of radiation after that. Unfortunately, that was not curative and so that required additional therapies and included first line hormone therapy, second line hormone therapy. I've had another surgery. I've had chemotherapy, immunotherapy, another second line hormone therapy and right now I'm looking down the barrel at potentially another surgery or radiation because I'm becoming refractory to several drugs and so I need to find some new answers. And the good news is that I do have a menu of new options to choose.

Based upon what I know today, would I have changed my decision? No, I don't think so. I think I made the right decision. So making that decision between radiation and surgery, I went about it by talking to doctors, doing my research, talking to other patients. And really what it came down to was that if I did surgery, I would do less damage to the surrounding tissue that would occur from radiation, and so I decided to do a robotic assisted prostatectomy. And so that was really kind of the driver, which was to say, "Well, if something does go wrong and it's out there, a plan B would be radiation." And so that was sort of like my thinking.

Nicholas Mosca:

At the time I went to see a specialist in radiation therapy and a surgeon who did prostatectomies and decided that, for me, I needed to have a provider that I felt was staying current with science. I thought that if I went to a place where there was an educational component where medical students and residents were trained, that would mean that they were reading journals and not just going to CE every six months. I wanted to find a provider that was comfortable in the deep end of the pool, not the shallow one. That's kind of how I thought about it.

So I decided to go to Tulane Medical Center. A friend said that they had a prostate cancer center and the experience I had was different than when I was seeing the private providers. First of all, I saw the private providers separately, different appointments, and to have everybody come in and talk to you at the same time or in sequence was valuable. I was able to ask questions.

So the first person was the internal medicine or the oncologist and he told me what the options would be and that people who specialize in those procedures would be coming into the exam room and talking about it. I think the first was the urologist. I was really impressed that the surgical technique used was robotics. I was a little concerned about the traditional surgery because of the longer healing and the higher risk for infection and so forth.

Next was the radiation therapist. She was very smart. I was impressed, but I also will have to say that I didn't quite understand everything at the moment, but I still felt like she was reading the journals, staying on top of the latest science and that she was using critical thinking. So I felt really comfortable.

But then I opted to have the surgery mainly because I feel that if you have abnormal cells and they can grow, better to get rid of the source. I just thought that was the way to go. You have to weigh the benefits and the disadvantages, so things like impotency and incontinence and some of the side effects that can happen. The risk of getting an infection is higher with surgery, obviously probably than with radiation therapy, but that was the decision I made and I'm glad I did make it. The surgery went well, I recovered quickly. It was good.

But I guess I would just kind of end by saying that it's still a difficult situation because it's hard for most people to understand the medical science and so you have to be able to feel trust in the people that you're seeing to move forward on decision making. You learn to use the muscles, I think they call it the Kegel reflex or something like that, where you have to kind of learn. It takes a few months. I was wearing pads.

The challenge is to understand the therapies and to feel as if you're making the decision and that you can stand by the decision you make as opposed to second guessing or feeling that somebody's doing something and then later you feel, "Oh, why? Why did they do that? Why did I listen?" That kind of thing. So I believe it's important for people to learn through the experience and if they feel that they don't understand what the individual's saying or if they feel like they're just being told to do it, I would doctor shop.

Rickey Lee:

The easy part was the surgery, believe it or not. The hard part was the thinking about it. I thought about it every second of my life. Every day I would fake the day along, I would try to laugh. I would try to be myself and I couldn't, but the day that we decided that it was going to be one and done, Dr. K gave me a lot of options and they were great options, but we went home that night.

He told us to go home and think about what we wanted to do and that's what I loved about him. He didn't push it. He didn't pressure me. He didn't push me. He let me make my own decisions and we came back. My wife calls it one and done, and we did the one and done and that was probably the most beautiful day of my life.

Primarily when we got the PS scores we kind of knew something was wrong and we had another doctor, I'm not going to call any names, but she recommended us here and I think God sent her to do that, just that, and sent Dr. K to do what he needed to do. And so I realized that today, you know what I'm saying? And so when Dr. K came into my life, I was scared. I've never really had a confrontation that deep with a doctor before. It's always in and out, regular exam in and out.