This is the tale of two gentlemen who had treatment decisions to make, and found they needed to think not just as patients, but as consumers, too.

Jack was told he needed surgery to treat his prostate cancer. Jack knew his neighbor had a similar diagnosis last year, and had opted instead for radioactive seed implants, a less-invasive form of treatment. Jack was a bit perplexed about why his surgeon hadn’t mentioned seed implants to him, too.  Jack wrote and asked if I knew the differences in benefits between those options.

I never make treatment recommendations, or even try to describe treatment options.  However, this struck me as being more a question of knowing about the skills and capabilities of the surgeon and less about what the options really were about.

So I asked Jack what kind of doctor he had visited and whether he had asked that doctor about the differences.  He replied that his family doctor had referred him to a urologic surgeon.  The surgeon had insisted to Jack that surgery was the better choice.

I shook my head as I replied to Jack.  Of course! A surgeon will recommend surgery because that’s his training, and that’s how he makes his money.  A surgeon makes no money on radioactive seed implants.

I suggested Jack get a second opinion from a urologist who was not a surgeon, who would explain a variety of options, including seed implants, chemo, surgery, and others. Only then could he make the right choice for himself.

A few weeks later, Melvin contacted me.  He, too, had a diagnosis of prostate cancer, and had been told he needed laparoscopic prostate surgery. Before writing to me, Melvin had done enough research to know that in some more advanced hospitals, prostatectomies are being done with robots, and that there may be lifelong benefits to that less-invasive approach. Melvin was concerned because his surgeon had recommended against using the robot. Based on what he had read, that didn’t make sense to him.

I asked Melvin whether he knew if the surgeon had been trained in the use of the robot. So Melvin inquired.  It turned out that no, the surgeon did not have that training.

You already know the answer I gave Melvin. The surgeon wouldn’t recommend something he didn’t know how to do himself. Melvin would do better to talk to a surgeon who knew how to use the robot, do laparoscopic procedures, and any of the other possibilities. 

So he looked around, and sure enough, Melvin was able to find a second-opinion surgeon who could handle the spectrum of prostatectomy possibilities. Now he can make a better-informed choice.

When you are given treatment recommendations, think like a consumer, not just like a patient. Many doctors will make recommendations based on what their training is, their familiarity, convenience, insurance coverage, or how much money they can make.

It doesn’t mean those are bad treatment options. It simply means you don’t have all the information you need to make the best choice for you.

If you think there’s a possibility those factors have influenced your doctor’s recommendations to the exclusion of others, then seek another opinion from someone who can provide additional recommendations, or can provide a counter-point to your first doctor.  

This advice holds true whether we are talking about prostate surgery, or any form of surgery.  If your recommended treatment is at all invasive, you need far more information than one doctor can give you.

Arming yourself with additional knowledge will help you realize your best medical outcome.  Thinking like a consumer is sometimes easier than trying to think like a patient.