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Stop Keeping Up (and Down) with the Joneses

Don’t Get Caught in a Thought Trap When Making Decisions about Prostate Cancer

by Andrew J. Roth, MD

Author of Article photo

Dr. Andrew Roth

It’s easy to compare yourself to men who look healthier than you and wonder if you will have their good luck. You may make negative self-comparisons with others who look stronger and healthier and wonder, How come my luck was not as good? It is even more unsettling to see someone who looks more ill than you and wonder if that is the road you will be heading down, and when.

Comparing your own situation to another’s is risky because there is a very large margin for error. Men with prostate cancer may have different cell types and different stages of disease at any point in time, as well as at the time of diagnosis, and they may have had different treatments or different regi­mens of the same treatment.

Medical care always needs to be individualized. This is why Internet hunting can be so frustrating. Men tolerate the same treatments differently and have diverse complications. Every man comes to his prostate cancer expe­rience with a different genetic and physiological makeup, having had unique life experiences and losses, as well as having developed his own coping patterns for dealing with those experiences. Each has distinctive sup­port systems and health problems. Men have unique needs for the amount and type of information that will help them make the best treatment and life deci­sions for them.

Comparing your own situation to another’s is risky
because there is a very large margin for error.

If you start to freak out because you think you made, or will make, the wrong treatment choice, remember some of the thought traps you might be stepping into. Uncertainty can pull you in the wrong direction. When you start feel­ing this way, try using the DRAFT technique:

Detect the anxiety or fear.
Recognize where the anxiety is coming from.
Acknowledge the rational and irrational aspects of your thoughts: I am worried that I did not (or will not) make the correct treatment choice; I am worried because I want to live a long and healthy life and now I am scared that hope is compro­mised; I am worried because my friend’s erections did not get better after surgery and that might happen to me.
Flip to the more rational, glass-half-full aspects of your life and health circum­stances, often beginning with the word however: However, I sought expert opinions and asked around and I read a lot of material. I am feeling pretty healthy otherwise. I’ve made excellent decisions in the past. I have to believe that my treatment was/will be the best choice for me when I made/make it.
Transform the somber, anxious feelings or thoughts through distraction into some­thing more life-enhancing right now: Let me pull out my crossword puzzle while I’m waiting, or Let me take a walk with my partner or call my daughter.

Information from others and the Internet can sometimes be useful. Other people can help you understand general parameters or responses, as well as help you see that you can get through the treatment, overcome complications, and be able, after the tincture of time for physical and emo­tional recuperation, to speak about it in an encouraging way. However, it is important not to take any information too literally and to try not to generalize from any one situation to your own.

Just as statistics can be confusing and inadvertently deceptive for a man who wants to know where he will stand in the future as a unique entity, it is problematic to generalize from the experience of one or a few men and believe that is how you will wind up. Have you ever purchased an item you were disappointed with that a friend raved about? Or have you listened to a highly recommended “could-not-miss” song, or read a “great” novel, or seen a “fantastic” movie and felt let down?

It doesn’t mean you shouldn’t listen to others’ experiences and recommenda­tions about their choices and perhaps try some out; however, the listening about health issues must be done with a dis­cerning ear – this is information that you will assess in the context of your body and lifestyle, but will not be a blanket guarantee of a particular outcome. It is important to keep these concerns in mind to avoid the all-too-common thought trap of overgeneralizing.

♦ ♦ ♦ ♦ ♦

Dr. Andrew Roth is the psychiatry liaison to the Genitourinary Medical Oncology Program at Memorial Sloan Kettering Cancer Center in New York, NY, where he has helped men and their families navigate the uncertainties of a prostate cancer diagnosis for the last 20 years.

Excerpted from Managing Prostate Cancer: A Guide for Living Better. Oxford University Press, 2015. Copyright © 2015. Reprinted with permission.

This article was published in Coping® with Cancer magazine, May/June 2016.