Podcast: Why a health care journalist chose active surveillance for prostate cancer

We have written dozens of stories and reviews on screening for prostate cancer. But once a man is diagnosed he is faced with a complicated — and often intimidating — menu of treatment choices.

Left: Howard Wolinsky, Right: Dr. Chris Warlick

As a health care journalist, Howard Wolinsky made it his business to understand these choices when he was diagnosed with prostate cancer. He chose no immediate treatment. More specifically, he chose an approach called “active surveillance,” which has gradually become more widely utilized by men with less aggressive disease.

Stories of men who choose active surveillance are not often told. Our news media commonly emphasize the experience of men who choose more aggressive treatment approaches. But that emphasis may reflect the incentives of commercial interests in our health care system rather than what is best for patients. That’s why we think it’s important to tell this story.

Besides Wolinsky, this podcast features Dr. Chris Warlick, a urologist who runs an active surveillance program at the University of Minnesota. Dr. Warlick and Mr. Wolinsky touch on several topics in this roughly 15-minute podcast including the basics regarding prostate cancer, our approach to cancer and risk in this country, the potential of truly shared decision making, what active surveillance is and is not, and the difference between active surveillance and watchful waiting. Howard also tells a compelling story of being asked to share his story with urologists at a cancer conference, and then almost going unheard.

More than one urologist has referred to Howard Wolinsky as a “poster child” for active surveillance. But he could also be seen as a role model. It’s inspiring to see how he has educated himself so he could take a more proactive, rather than passive role, in his own health care. Following his lead we offer the following resources for those of you who might want to dig deeper.

• Wolinsky’s series, “A Patient’s Journey,” on MedPageToday.

• How has the media handled active surveillance? Some examples from the New York Times and Chicago Tribune

• We’ve written quite a bit on shared decision making, but don’t miss this very simple but powerful advice on being a proactive patient from two Cleveland Clinic doctors

• Here is a look at how active surveillance differs between the United States and the United Kingdom (and what about the very high active surveillance rates in Sweden?)

• Finally, it’s almost impossible to talk about anything related to prostate cancer and not bring up the issue of screening. Our publisher and founder, Gary Schwitzer, considers this article a must-read

You can find all of our podcasts on this index page – 27 (so far) and counting…