Re: Can't get PSA to zero
I've dealt with many doctors over the years, and I wish I could say I've learned how to do it. Every doctor is different and has his own set of ego and personality issues, values, biases, and communication styles, just as we all do on the patient side too. It's a difficult relationship to negotiate when we might only interact for a furtive hour, yet no relationship we form outside of family and close friends is more important to our continued well-being. One thing I've found to be universally effective is learning to speak their language. It changes the whole dynamic. However, how many of us are able to do that? I've also learned to be very non-confrontational -- nothing gets those ego barriers up like a direct challenge. When I present research to them (usually via email so that they have time to look it over), I put it in the context of something like, "I saw this new study that you've probably already seen. What implications might it have for my treatment?" For me, it helps a lot if the doctor has a lot of academic curiosity (i.e., a nerd) although such people may have less developed social skills. Often, I find such doctors who are willing to work outside of the "standard of care" at major university hospitals and cancer centers with notable exceptions like Drs. Scholz, Lam, Myers, etc.
And then there's the battles with insurance companies... don't get me started!
I hope you will let us know if you have success getting Xtandi. If I had to pick one medication that's currently available that's worth fighting to get, that would be it. Zytiga's good too, and there should be no impediment to getting it now.