[Jim]
 
It's hard deciding what treatment is best for my prostate cancer. Even the doctors seem to have different views. And so do many of the guys I know who have had the same problem. My wife and I have a system we use when trying to decide about a problem. We start by listing all of our important issues on a sheet of paper. For my treatment decision, we decided to list the things we value most in life. Quality of life issues are very important to us. I play golf and am active in other outdoor activities, like hiking, camping, and fishing. My wife and I have also enjoyed a good sexual relationship. So, the possible side effects of treatment for prostate cancer -- impotence and incontinence - are really something for me to think about.

[Jim]
 
The specialist told me that my tumor is very small right now and he said some cancers grow very slowly. And, depending on the size of the tumor, the type of cancer it is, where it's located, your age, and other factors like race, one option for treatment may be "watchful waiting." This means not doing any actual treatment right now, but keeping a close eye on the tumor. The doctor did say that it was important for us to understand what could happen if we choose "watchful waiting" -- that my cancer might spread quickly and it might not be able to be controlled then.

[Jim]
 
While I would love to avoid surgery or radiation treatment, "watchful waiting" sounds very hard to me. I've always liked to take action, to get things over and done with. I started wondering if I would always be thinking about my tumor and be worried that it was growing. It seems like I would have to go for checkups all the time to be sure I was still okay. I also had some concerns about the radiation treatment. So, I kept asking myself, wouldn't it easiest to just have the surgery, get the tumor out, and then deal with any side effects, if they happen

[Jim]

I decided that the best thing was to get information about treatment side effects. So, I talked to my doctors some more, and got information from several reliable sources on the Internet. I found out there are a number of therapies available today to help with side effects, and that even the surgery has changed - they now do what they call "nerve-sparing" surgery to help prevent problems. I decided that the surgery was the best option for me.

[Narrator]

Keep in mind, too, that treatment decisions will be influenced by your type and stage of cancer and by other medical conditions you may have. For example, "watchful waiting" may be a treatment option for some prostate cancers, but it is never an option for breast cancer or for most other cancers.

[Narrator]

Another important area where we need to use good decision-making skills is on end-of-life issues. You have a legal right -- and a moral right -- to decide what kind of medical treatment you want -- or don't want -- if you become seriously ill. Making these decisions ahead of time and putting them in writing in a legally valid document will help make sure that your health care team and family follow your wishes if you are not capable of communicating when the time comes. Listen to how Ruth took care of this decision.

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