Importance of Medical History
 

An Opinion by Don Cooley


If we operate on only part of the information the advise given could be dangerous to the patients health. For this reason I have included this information as advise to new patients as to how important it is to give your history to get the best help.  Be sure to let everyone know (including your doctors) if there is any prostate cancer or breast cancer in the family.


In this section we have two such forms.  The first one is called "Form for PC Digest" which is the form you will want to use for your doctor visits and in any forum, meetings etc. that you might want to ask questions.  The second form called "Questions Form" is for the use of asking our Team questions (any question) about our disease, treatments, how it effects family life, ED, etc.  The second form is a more condensed form and the Team may ask for additional information.


One of the first things a doctor in training is taught is how to take a case history. Oftentimes when they get into practice it is relegated to a nurse or some one else in the office. Sometimes I think that the doctor never looks at the file - perhaps more so the first time but less so from there on out. The result is that we get prescriptions that may conflict with other prescriptions, things that he was going to do next time and forgotten when next time is here, etc., etc., etc. All treatment recommendations and all treatment decisions have to start with a complete case history.


The same thing applies when you are talking to people who have had prostate cancer.  You ask them a question and they give you an answer.   Frequently the data supplied is really not enough to answer the question.  In this case you probably received the wrong information.


I noticed this some years ago that questions were being answered with inadequate history and have made a concentrated effort to get the newly diagnosed to give a history. Then often times they sill do not answer the questions we need. I have revamped this form, rewritten the introduction, added and subtracted information requested - all at various times through the years to make it clear that we need this history. Recently because of the studies I have added weight, weight gain and Diabetes questions on the form. Yet no matter what I do frequently the patient does not understand the importance of the data.


I believe the data is necessary to make a proper suggestion for treatment or whatever one is asking. The newly diagnosed may not understand the importance of the information. This is like going to the doctor and the doctor not reviewing your history before he suggests what you need. There is nothing like it anywhere for the newly diagnosed and it is a place where every man needs to start when he gets those words "you have cancer".


The items on the form are items that every doctor should know and have in the records for review but I am afraid that many, if not most, do not understand the consequences of the interplay of the various data - and neither, oftentimes, do we - although there are some who probably surpass the understanding of most doctors about our disease.


There is an old saying that the three most important things in real estate is location, location, location. I believe in prostate cancer it is, case history, case history, case history. The diagnosis is a significant part of the case history but it is not the as important as the complete case history.


Lets revive the art of reading a case history and use our knowledge and the information provided to give the best advise we can based on ALL available knowledge. If the information is not there ask for it and when it comes you will have to review the original post along with the new material to answer.


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