Your Medical Mind_ How to Decide What Is Right for You - Jerome Groopman [39]
Matt flew out to see this surgeon, who explained that he performed a traditional operation, a so-called open procedure, rather than using a laparoscope with robotic assistance. “In my hands, it’s the best way to a cure, and I can see the nerves clearly and preserve them so you won’t become impotent.” In the past, Matt would have been impressed by the surgeon’s confidence. But he thought back to the urologist who had assured him that everything would be fine, that he didn’t have cancer. So now he had doubts. He wasn’t ready to commit to this surgery yet. He would explore other options, like robotic surgery or radiation.
It wasn’t difficult for him to secure an appointment with a well-known radiation specialist. After sitting for nearly two hours in a waiting room decorated with several photos of local celebrities, each inscribed with thanks to the doctor, he was evaluated by a medical student who took his history and performed a rectal examination. Next, a resident came and did the same. “So after these young doctors examine me, the boss comes into the examination room and says he wants to do yet another digital rectal exam. I had now had four normal prostate examinations in the last month, two of them in the last twenty minutes. And I have the images from the normal ultrasound study in my hand.” It had been nearly three hours since Matt had arrived at the office. “I told him I really preferred not to have yet another rectal exam. I came here to discuss treatment options. But he said that if I didn’t want a digital exam, I might as well leave. I considered going, but since I had invested this much time already, I let him do the examination. Again, normal.
“The specialist then casually flipped through my pile of records and said, ‘You know, for anyone of your age who wants to keep his sexual function intact, radiation is really the way to go. Surgeons will tell you they can spare the nerves, but even with robotic surgery it often doesn’t work.’
“I was really annoyed by this visit, and I was totally uninterested in spending any more time in that office,” Matt said. “But that didn’t mean that radiation was necessarily out.” He had learned as an investor not to make decisions in the heat of the moment. “I looked at the photos on the way out—clearly he was the top guy. I needed to give it more thought.
“Proton beam popped up in my research,” Matt continued.
Proton beam therapy uses a special kind of high-energy particle. Doctors who offered the treatment contended that you could focus the high-energy beam more accurately than with classical forms of radiation. The focused radiation theoretically was better able to spare the healthy surrounding tissues and eradicate the cancer in the gland with less toxicity. Only a few hospitals around the country had the technology to deliver this kind of radiation.
“It seemed elegant, just the kind of nuanced difference I was looking for,” Matt said. “I called a friend, and he put me in touch with one of his business partners who was treated with proton beam. When I called the man, it turned out that not only was he treated there, but he had been involved in the start-up financing. He just raved about it.”
Matt Conlin was trained as an engineer before entering finance, and this background began to guide much of his thinking. Here, he told us, was a precise, controlled beam that would reduce as much as possible the risks of the radiation. “It made sense to me.” So he prepared himself to relocate to a medical center with a proton beam unit in Southern California. “It seems like I have contacts everywhere, and I wasn’t shy about using them. An associate there had a guesthouse