治疗前列腺癌，有时少即是多

告诉我们你的诊断和你对此的反应.

2006年，我被诊断出患有早期前列腺癌. 幸运的是, the urologist who diagnosed me explained that with early-stage 前列腺癌, 在做出治疗决定时没有紧迫性. 所以作为分析者, 我是一个数据驱动的人, 我花了三到六个月的时间做了大量的研究, to learn as much as I could about the disease and the treatments that are available.

I researched every top medical center, one of the best of which was UCSF Medical Center. I set up appointments with six specialists, the last one being 彼得•卡罗尔.

为什么加州大学旧金山分校在你的名单上?

我对加州大学旧金山分校了解得越多，印象就越深刻. 它确实是十大赌博平台排行榜上同类机构中的领先机构之一, 和一些最优秀最聪明的医学科学家在一起. So to me, it was just logical that this is the place you would want to be if you were a patient.

你为什么选择博士. 尤其是卡罗尔?

I researched each of the specialists I had a consult appointment with and found a lot of data on their performance. 彼得的数字非常出色.

一号, he had done these procedures thousands of times; you always want someone who has done it thousands of times. 而一个普通的外科十大赌博平台排行榜会有30个, 40 or 50 percent of patients experience side effects such as sexual dysfunction or incontinence, 在彼得的情况下, 这个数字更像是5%. 也, 采收率, the bleeding – with all the signs you would use to judge the quality of the surgeon, 彼得的数字远, 远远好于平均水平.

When I mentioned his name to other urologists, everyone said he was considered the best.

那次拜访发生了什么事?

I went through all my material and asked him what he thought: Should I do surgery? 我应该做放疗吗?? 什么是最好的?? 我是一个年轻健康的人.

他的回答是惊人的，非常鼓励我. 他说:“我有另一个选择. 都做不到.我说:“你是说警惕地等待。?他说:“不。. The problem with watchful waiting is there is too much waiting and not enough watching."

然后他继续向我解释主动监视. 这是一个非常仔细评估和衡量的前瞻性项目, 以定量的方式, 你的病在哪里, 不管它是否在进步. If and when it does progress, then you can make a decision about a more intrusive type of treatment.

他告诉我的另一个重要事实是, 如果一个接受主动监视的人需要治疗二, 三个, 五年之后, the success rate and result of the treatment are equal to or better than for men who chose to have the treatment immediately.

Were you surprised to hear that from someone you'd chosen as an eminent surgeon?

It was amazing to me that a world-class surgeon would tell me I shouldn't have surgery. 这让彼得对我来说是一个独特的班级. 他是一个非常有逻辑，客观的人，真正把病人放在第一位.

除了他是十大赌博平台排行榜级的医学家, 内科十大赌博平台排行榜和外科十大赌博平台排行榜, what struck me about him when he first walked in the room was that he's a very unassuming, 有爱心的人. 在我认识他的这些年里，这种最初的印象一直很牢固.

选择不治疗困难吗?

It's important for any newly diagnosed patient to think of 积极监测 as an active way of being treated. 我觉得自己在接受治疗, 因为有很强的电流, 不断了解我的病情, while at the same time not having the risks that go with invasive treatment. A patient on 积极监测 should feel just as secure as a patient having surgery or some more intrusive type of approach.

I feel very confident that world-class experts at UCSF Medical Center are constantly monitoring the state of my disease, 如果发生任何变化, they will be there in a very timely way and we'll make the right decision about what to do. 在那之前，我的日常生活非常舒适.

And I think that that level of confidence in your caregivers is hugely important when you're in something like 积极监测, where the quality of your doctors' thinking and their attentiveness are so critical. That's an underpinning for my whole attitude toward it: the consistency of care, the follow-up.

主动监控对你来说是什么样子的? 随着时间的推移，你在加州大学旧金山分校的护理有变化吗?

I have been on basically the same 积极监测 routines now for almost 17 years. 多年来, 它是每三个月进行一次前列腺特异性抗原(PSA)血液检查, 每六个月做一次超声波检查, 然后每隔18到24个月做一次活检. 最近, because I've been fortunate not to have really any progression of the cancer, 我们后退了, 我每六个月要做一次公益广告, 每年做一次超声波检查, 每年去一次办公室. 我已经很久没做活组织检查了, ,最近, 大约两三个月前, 我做了核磁共振检查，没有进展. 一切看起来都很棒.

The fundamental routine hasn't changed, but the technology has definitely improved. For example, when I had an MRI a few years ago, it was a bit more invasive than it is now. 数字工具也让事情变得更容易. 我住在洛斯阿尔托斯，开车到加州大学旧金山分校可能需要很长时间，而且交通很糟糕. 对于最近的核磁共振成像，我们安排了一个视频访问来回顾结果. 我们能够集中精力，进行一次彻底的交谈, instead of it taking me 三个 hours to do a round trip and probably have less time. 我觉得太棒了.

对我来说，另一件伟大的事情是新的 [米申湾]校园. 那里太棒了，从半岛去那里更方便.

在主动监控下你的日常生活是怎样的?

The strongest, most positive thing I can say is it hasn't affected me at all. I have lived exactly the same life I would've lived if I hadn't been diagnosed. Essentially, I maintain my normal quality of life, other than periodically having a few tests. 生活对我来说很好.

我认为这是一件大事:我的生活还在继续. 不久前, 我和我的心脏病专家做了一次彻底的检查, 他告诉我, “你还能再活20年. 你没有任何问题." And I was sitting there thinking about that, and I was reflecting on 前列腺癌. 我想，我现在坐在这里，比以往任何时候都要老. 奇怪的是，我感觉更健康了. 我现在79岁了，其他方面都很健康. 我已经有16年的高质量了, 影响生活, 这很容易就会有很大的不同.

I hope my experience can be a model for other patients: You can begin 积极监测 and potentially go through the majority of the remainder of your life without ever having to do anything. 我得到了非常积极的纵向结果. 我不担心. 我不去想它. 我按要求做测试. 知道并追踪我自己的号码, 对我的护理团队充满信心, 我真的不太担心.

你如何描述你在加州大学旧金山分校的经历?

它非常出色. Every staff member I've interacted with has been not just extremely competent, 但也很友好和风度翩翩. 我极力推荐一所学校.

加州大学旧金山分校在文化上让我想起了硅谷. 它是开放和协作的. That's the kind of environment that allows scientific advances to be made and creative new concepts to form, 得到滋养和成长. 主动监视就是一个例子.

我的妻子, 唐娜, and I both feel that UCSF encouraged us to be active participants in our own health care. 你不仅仅是十大赌博平台排行榜和病人. 你们是医疗队. 我们是团队的一员.

2006年我们走进彼得办公室的时候, what was looking like a potentially horrible illness experience became a positive new dimension of our lives. 我们现在把彼得看作私人朋友. And we've become very involved in advocacy and patient education work related to 前列腺癌 and 积极监测. 唐娜和我有个座右铭:把问题变成答案. 这次经历就是一个很好的例子.