The Most Aggressive Treatment is Not Always Best


Bob Riter
Bob Riter

There’s a bit of cowboy in many of us when we’re diagnosed with cancer. Often our first response is to want the cancer removed right away with the most aggressive surgery possible.

I hear this commonly in men who are waiting the results of a prostate biopsy. They say, “If it turns out to be cancer, I want it out of me RIGHT NOW.”

This thinking is not restricted to men. Women with breast cancer are sometimes given the option of a lumpectomy (followed by radiation) or a more extensive mastectomy. Although the long-term survival rates are equal, some women may request the more extensive surgery because they equate bigger surgery with more effective surgery.

There are times that the most aggressive cancer treatment is, in fact, the best cancer treatment. I’m just wary if I sense that decisions are being driven by anxiety.

Prostate cancer, for example, is rarely a medical emergency. Men who want immediate surgery are usually anxious (which is understandable with a cancer diagnosis), but decisions shouldn’t be made before gathering the facts, weighing the options, and catching one’s breath.

There is an important distinction to be made between anxiety and instinct. Anxiety is not your friend when making treatment decisions because it can cause you to make decisions too hastily or it can cause you to spin in circles and decide nothing at all. If anxiety is driving your decisions, talk with your physician and try to get it under control.

Instinct, on the other hand, is worth listening to. I like it when people investigate the pros and cons of a decision and then sleep on it. This can be especially helpful in deciding on a physician or a course of treatment. Information should guide your decision-making, but sometimes the final decision is made in your gut.


Reprinted with permission of the Ithaca Journal.
Original publication date: Nov. 8, 2014