The Elder Zone - Prostate Cancer Part III
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Prostate cancer remains among the most diagnosed male cancers in America, with surgical intervention serving as a primary treatment approach for many patients.[1]
This is the story of how prostate cancer for a man is a maze that leads from one dilemma to another, posing questions to which there are no right answers.
I posted Part I of this saga on August 28, 2025.
https://www.coachingwithwisdom.com/blog/the-elder-zone-prostate-cancer
I posted Part II on January 20, 2026.
https://www.coachingwithwisdom.com/blog/prostate-cancer-part-ii
At the end of Part I, two super-doctors diagnosed me with prostate cancer.
Mostly for the uninitiated, Part II describes various methods of diagnosing prostate cancer (as of 2014) and the little tortures inflicted on the patient along the way.
I then return to the same problem: what to do when two “world-class” experts disagree on how to treat your PC?
Part III:
· clarifies some questions I have received since posting Part I;
· discusses the patient’s dilemma of what to do when he seeks a second opinion[1], and it is significantly different from the first;
· explains how I resolved that dilemma; and,
· demonstrates how, like a Chinese puzzle box, one dilemma leads to another.
Clarification
As stated in Part I, my journey with prostate cancer began in 2011.
What I have described so far occurred in 2011-13.
Some of my readers thought I was describing an ordeal I have been going through recently.
My apologies for the confusion.
Be patient.
I will bring you up to speed.
Spoiler alert: the final chapter has yet to be written.
Indeed, you may discover, as I have, that once you get cancer, you never really get rid of it.
All you can do is accept it and do your best to manage it.
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Resolving Conflicts Between Experts
Returning to my narrative:
At some point, the fact that you have cancer is undeniable.
In some ways, that is the easy part.
Soooooooo – what are you going to do about it?
In Part II, I described the typical forms of treatment back in 2013.[2]
When it came to treating my cancer, one “world-class” doctor told me to step on the accelerator; another told me to pretend I was driving through a school zone.
In other words, one said, “You need treatment as soon as possible.”
The other said, “It’s July. Let’s wait and see how things look next February.”
How does a patient resolve differences of professional opinion like that
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My Dallas doctor was candid enough to tell me that he was not sure what to do.
He planned to poll his peers and ask their opinion.
This was a case involving “intraductal” prostate cancer, which was relatively rare at the time and I expect still is.
Lucky me!
When I heard that my Dallas doctor was consulting with doctors across the country, I decided to do the same.
I find that when you confront a dilemma, whether about cancer or anything else, the best approach is to keep asking questions.
There may be no “right answer,” but there will always be a best option.
If you are in a fog in London, keep stopping locals and asking for directions.
Eventually, you will find Buckingham Palace.
One of the deciding factors for me was that after this medical dispute broke out over whether to go ahead and treat the cancer or monitor it[3], my Dallas doctor decided to give me another round of diagnostics, including another biopsy and an MRI.
I assertively asked him to sit with me and go over the results.
Sometimes, this is how you have to be with doctors.
The biopsy images looked identical to those from the first biopsy.
Despite what appeared to be identical biopsies, his opinion “not to treat” changed.
He later changed it back!?
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The MRI told a different story.
I was reading every book I could find on prostate cancer and ran across one I liked, written by a doctor from New York.
I contacted him, and he asked me to send him the MRI ima
My Dallas doctor (sometimes referred to as that “blind bastard with the red glasses”) and I reviewed them, but he saw nothing important to point out.
The New York doctor, however, saw an image of a tumor breaking out of the prostatic capsule!!
It’s one thing to have a tumor; it’s another to have one that wants to visit your other organs.
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Synchronicity
The famous psychologist, Carl Jung, may have described what happened next as “synchronicity.”
For reasons only the universe knows, I reconnected with an old friend from high school.
At that time, he was practicing medicine in San Diego.
And he had a good friend who was a urology professor at UCLA.
He introduced me.
One way to resolve any conflict between experts is to find another expert who “does not have a dog in the fight,” as we say in Texas.
In other words, he was unbiased.
After hearing my story, he was emphatic that I needed treatment soon before the cancer had a chance to spread further.That resolved the dilemma of whether to treat it or monitor it.
The next dilemma was whether to treat it with radiation or surgery: pros and cons to both approaches.
I flew to LA and met with yet one more world-class surgeon to discuss this.
He and my friend had good reasons why surgery was the better option.
Now feeling the urgency of the situation and having two doctors I trusted, I followed that advice: another dilemma resolved.
The moral of the story is: KEEP ASKING QUESTIONS!
You will find Buckingham Palace.
It may not be what you expected, but you will no longer be lost.
Funny how when you think you are at the end of a story, you find out that you are at the beginning of another story, just like a damned puzzle box!
The conclusion of surgery marks not the end but rather the beginning of an ongoing monitoring relationship with healthcare providers.[4]
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Coming Attractions
· My next dilemma: radiation after surgery?
· Walking with a Catheter.
· No solid food until …
· The aftermath
o The pump
o The immediate impact on a relationship
o Impotence and Incontinence
o Insomnia and Depression
o PSA tests forever?
o Remission
o Recurrence
[1] For the importance of seeking a second opinion, see Jamie Catmull’s recent article (May 1, 2026): He Was Told He Needed Surgery for Cancer: A Second Opinion Changed Everything
https://nifty50plus.com/2026/05/01/he-was-told-he-needed-surgery-for-cancer-a-second-opinion-changed-everything/?utm_source=rss&utm_medium=rss&utm_campaign=he-was-told-he-needed-surgery-for-cancer-a-second-opinion-changed-everything
[2] Since then, as you would expect, new forms of treatment have been developed. Make sure your due diligence is up to date.
[3] Commonly called “active surveillance.”
[4]Id.
[1] What really happens during prostate surgery recovery
https://rollingout.com/2025/03/11/what-happens-during-prostate-recovery/?utm_source=flipboard&utm_content=topic%2Fprostatecancer<https://flip.it/BbIEaP>