|When I first saw this patient, there was a note in
the chart from the front desk saying “patient does not read”. I asked if
this was a deliberate decision from the patient, or whether they had meant
to say that the patient was illiterate and could not read.
Unfortunately, the latter is true. The patient is a retired janitor who is
This poses a difficult situation because I diagnosed him with prostate
Well, there wasn’t much of a discussion with this patient because he did
The patient is quite pleasant. He will follow all the instructions we give
This was an interesting dilemma a colleague of mine faces as she write son
This is a great post and will add it to my blog to see what my readers think.
I have to preface my answer with the disclosure that I am a urologist who does
4-6 robotic prostatectomies per week.
I always recommend a second opinion and often have patients ask me to decide for
I had one patient who I biopsied who was very similar to yours, but fortunately
did not have cancer.
My suggestion to you would be to choose for him what you would do for your dad
if it was him.
If you think incontinence would be too much, then radiation has a major
advantage. If you feel that anesthesia is best to be avoided, then external beam
would be the way to go.
If he is young and needs surgery in your opinion, I would recommend that.
The society frowns upon paternalistic physicians (and probably rightfully so),
but this is a good example of paternalism working well.