Title: A Physician’s Experience with Prostate Cancer: Insights Gained from Being on the Other Side of the Stethoscope
By: Francisco M. Torres, MD
For most doctors, the experience of illness is experienced from a distance: we observe, diagnose, and treat from a place of clinical knowledge and professional detachment. However, that distance disappears when we become the patients ourselves. My recent journey through a prostate cancer diagnosis forced me to confront not only the emotional turmoil of hearing “cancer” but also the jarring realization of how disjointed and confusing the American health care system can be for those lacking medical knowledge or support.
The Surprising Diagnosis
A common precaution resulted in a life-changing revelation. Despite my doctor’s assurances that a prostate biopsy was only a precaution, I was taken aback when I logged into my patient portal to find the blunt words: “Positive for cancer.” Instantly, I transitioned from the confident physician who guided others through fear to a fearful patient engulfed in a world of clinical jargon, uncertainty, and dread.
Even as a physiatrist with training in physical medicine and rehabilitation, grappling with the biopsy results was challenging. Concepts such as “Gleason score” and biopsy percentages were recognizable yet felt distant, leaving me feeling overwhelmed. I faced the same confusion and anxiety that I had previously so effortlessly explained to my patients.
A System Tailored for Information, Not Comprehension
Contemporary medicine emphasizes transparency, and patient portals frequently provide test results almost instantly, often without adequate contextual explanation. While this may seem to empower patients, it can inadvertently engender crippling fear and misunderstanding, particularly regarding serious diagnoses like cancer.
I considered myself fortunate; my wife is a pathologist. She swiftly clarified that a Gleason score of 6 indicated a less aggressive, localized cancer. This knowledge provided me with a sense of grounding—but I couldn’t help but think, how would someone without that advantage fare? How many patients endure days or weeks of sleepless anguish, caught in uncertainty over whether a test result signifies life or death?
A Breakdown in Dialogue
When I finally had a conversation with my physician, he outlined various treatment options—active surveillance, radiation, and surgery—but did not thoroughly explain the ramifications of each, leaving me with more questions than clarity. Which option offers the best long-term survival rates? What are the long-term side effects? What does “active surveillance” truly entail?
Most frustratingly, my reasonable request for a PET scan was declined due to insurance guidelines associated with PSA levels—a decision that seemed to prioritize administrative processes over comprehensive diagnosis. I exited that appointment feeling marginalized and even more uncertain about my next steps.
The Necessity of Multiple Perspectives
Determined to make an informed choice, I sought a second opinion. This physician adopted a distinctly different approach—he asked additional questions, highlighted the importance of prostate size in treatment decisions, and was adamant about obtaining a PET scan regardless of insurance obstacles. He even introduced the possibility of DNA analysis of the cancer cells, an option not previously mentioned.
This contrasting experience yielded vital insights: the initial treatment decision could heavily influence future options—undergoing radiation first, I discovered, could preclude surgery later due to modifications in tissue structure. Why had no one communicated this to me before?
Such discrepancies in treatment approaches raised deep concerns about widespread systemic inadequacies. Are these differences a result of time limitations, specialization silos, or a lack of care coordination? How often are patients offered incomplete or contradictory information? As someone who believed that rigorous training equated to positive outcomes, these inconsistencies were deeply disheartening.
The Human Element in Medicine
This experience reshaped my interactions with patients. Terms like “biopsy,” “radiation,” and “surgery” now evoke visceral responses within me. I listen more intently. I pose better questions. I insist that patients fully grasp the advantages and drawbacks of treatments before proceeding. This ordeal has enhanced my empathy and, I hope, improved my abilities as a physician.
Yet perhaps the most sobering realization lies in how much my medical background and personal connections facilitated my journey. Many patients lack a physician spouse, oncologist friends, or the professional acquaintance to decipher pathology reports.
Towards a Superior System
This experience illuminated a stark reality: our health care system is not primarily tailored for patient comprehension. Access to data does not equate to understanding, and conflicting medical advice erodes trust. We must strive to provide not only information but also meaningful explanations. To genuinely support patients, clinicians must anticipate not only what needs to be communicated but also how and when to convey it.
We must also advocate for a framework that champions thorough second opinions, prioritizes patient care over paperwork, and ensures that treatment decisions are made collaboratively—where patients are involved as active participants rather than passive recipients.
Conclusion
Becoming a patient has irrevocably transformed me. It has enhanced my role as an advocate, not just for my own health, but for a more compassionate, communicative, and coordinated health care system. I now approach each patient with renewed vigor.