Article

Treatment Decisions: A One-Way Street?

Before cancer surgery, my wife and I get a second opinion and then a third. Here's why.

Treacherous the path that guides us here,

A twisting, narrow alley of fear.

Choices evolve. Sign posts appear.

Our travels begin, a chaotic scene,

Tests to be done and docs to be seen,

Experts renowned, supportive and keen.

Specialists confer, inspect every scan,

Surgeons poised to remove all they can.

Chemo, radiation round out the plan.

The pathway dims, were there signs we mistook?

Tired, afraid, we need a fresh look.

Second opinion, a travel guidebook?

We get the appointment with no time to spare.

Will they be helpful? Such rarified air

For neophytes to advanced cancer care.

If they concur, what will be the point?

If they disagree, whom should we anoint?

Either way, we fear, this will disappoint.

On two key facets they do disagree:

No bone grafts, radiate differently.

The crossroads reveal path number three.

Time to resolve this medical debate.

The clock is ticking; the hour is late.

A clinching vote makes our pathway straight.

The third group impressive, direct and clear,

Proton radiation? They have it here.

No need for bone grafts. Our doubts disappear.

Together for years, a team with passion,

For complex cases they are a bastion.

Midcareer experts, long on compassion.

Nine skilled surgeons, a twenty-hour fray,

Postop recovery, a two-week stay,

Protons for seven weeks, once every day.

Two years later we're scanning quarterly,

Getting this far, a mystery to me.

We hope some day I could be cancer-free.

Looking back now, what has our journey shown?

Ignore our doubts, the consensus unknown,

Or find the best team and make it our own?

Patients must grapple with uncertainty.

Seeking more options can block or set free.

For us the best choice was road number three.

Author's note:

Choosing a path is inherently subjective. All the clinicians we met during this journey were highly skilled, gracious and professional. They collaborated conscientiously with the other teams. We salute and thank every one of them.

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Dr. Alan Tan is a genitourinary oncology (GU) and melanoma specialist at the Vanderbilt-Ingram Cancer Center in Nashville, Tennessee; an associate professor of medicine in the Division of Hematology and Oncology at Vanderbilt University Medical Center; and GU Executive Officer with the Alliance for Clinical Trials in Oncology.
Dr. Chandler Park, a medical oncologist of Genitourinary Medical Oncology, at the Norton Healthcare Institute, in Louisville, Kentucky.
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