Houston, We Have a Problem

One of the great benefits – and curses – of dealing with cancer over a long period of time is that you learn a lot more about cancer than you ever wanted to know, but not enough to really know what to do next. In a weird sort of way, choosing what to do next was probably easier in an era where there was less hope, and less by way of treatment options.


Although I lived through that era, I was too young to know what choices patients were having to make. I suspect that treatment choices were quite a bit more binary at that time. There were fewer treatments to choose from and quite frankly, fewer doctors to choose from as there was not the same degree of subspeciality that there is now.


I have mentioned before that I am so fortunate to have a whole team of doctors looking out for me. Not only do I have the oncologist that has successfully managed my case for the last eight years looking after me, but I have a full team of oncologists at my workplace looking after me as well. Having five uber-qualified individuals looking after me is an incredible luxury that I do not take for granted, and that I appreciate beyond words.


That can also make things tricky though. I now have five clinicians with well over 100 years of combined oncology experience reviewing every one of my test results. Everyone seems to agree that we are in an important place in time, where my cancer is spreading but I am still not symptomatic. They all seem to agree that a treatment decision needs to be made and started soon. However, nobody seems to agree on what that treatment choice should be.

Meanwhile, I find myself in the somewhat confusing position of having tremendous respect for each of these brilliant doctors, not being sure of what to do next, and not wanting to offend anyone by not following their advice. I guess you could say it is the downside of having an “embarrassment of riches” when it comes to medical advice.


One member of my oncology team asked me last week to make a visit to MD Anderson in Houston to get the opinion of an oncologist there that deals almost exclusively with “genitourinary” cancers. For those that do not know, genitourinary cancers are what I jokingly refer to as cancers of the plumbing system. Said another way, cancers of the body parts you don’t really like to talk about in mixed company, if at all.


I am now checking into MD Anderson. This oncologist at MDA is incredibly qualified and by most people’s estimation, MD Anderson is one of the best cancer centers of excellence in the world. It’s a lot more work to go through to get accepted, but who wants to feel like they left anything on the table if they have an option? Hopefully, Houston can help with this problem.


Until next time,


Steve