约翰鞋匠的 前列腺癌 diagnosis launched the self-described "data-driven" former tech executive on a months-long research project. 当他降落的时候 Dr. 彼得·卡罗尔的 office, he knew a great deal about 前列腺癌 and the nation's top experts who treat it. 仍然, he was startled to hear Carroll's advice: Track your cancer closely, 但在必要时再治疗.
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Tell us about your diagnosis and your response to it.
Approximately six or seven years ago I was diagnosed with early-stage 前列腺癌. 幸运的是, the urologist who diagnosed me explained that with early-stage 前列腺癌, there is no urgency in making a treatment decision. 作为分析型的, 我是一个数据导向型的人, I reacted by taking 三个 to six months and doing a lot of research, 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.
The more I learned about UCSF, the more impressed I became. It is literally one of the leading institutions of its type in the world, with some of the best and brightest medical scientists. So to me, it was just logical that this is the place you would want to be if you were a patient.
I researched each of the specialists I had a consult appointment with and found a lot of data on their performance. 彼得的数据非常出色.
一号, he had done these procedures thousands of times; you always want someone who has done it thousands of times. 而一个典型的外科6686体育会有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%. 还有回收率, the bleeding – with all the signs you would use to judge the quality of the surgeon, 彼得的数字远不止这些, 远高于平均水平.
When I mentioned his name to other urologists, everyone said he was considered the best.
I went through all my material and asked him what he thought – should I do surgery, 我应该做放射治疗吗, 什么是最好的? 我是一个年轻健康的人.
His response was amazing and very encouraging to me. 他说:“我有另一个选择. 都做不到.我说:“你的意思是观察等待。?他说:“没有。. The problem with watchful waiting is there is too much waiting and not enough watching."
Then he went on to explain active surveillance to me. It's a proactive program that very carefully assesses and measures, 以定量的方式, 你的病在哪里, 不管有没有进展. If and when it does progress, then you can make a decision about a more intrusive type of treatment.
他给我的另一个非常重要的事实是, if a man on active surveillance requires treatment two, 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. That really put Peter in a unique class for me. He is a very logical, objective person who truly puts his patients first.
Separate from the fact that he's a world-class medical scientist, 内科6686体育和外科6686体育, what struck me about him when he first walked in the room was that he's a very unassuming, 有爱心的人. That initial impression has stood up over the years I've known him.
It's important for any newly diagnosed patient to think of active surveillance as an active way of being treated. 我觉得自己在被对待, 有一个非常流行的, constant knowledge of the state of my disease, while at the same time not having the risks that go with invasive treatment. A patient on active surveillance 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. Until then, I'm very comfortable in my daily life.
What's daily life like on active surveillance?
Essentially, I maintain my normal quality of life, other than periodically having a few tests. 我的生活一直很好.
How would you describe your experience at UCSF?
它非常出色. Every staff member I've interacted with has been not just extremely competent, 但也很友好，很有风度. I could not recommend an institution more highly.
UCSF reminds me a lot of Silicon Valley, culturally. 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. 主动监控就是一个例子.