What happens when the doctor becomes the patient?
In this ASPI educational session, physicians who have personally faced prostate cancer reflect on how the experience changed their understanding of diagnosis, uncertainty, treatment decisions, Active Surveillance, and patient care. The discussion offers a rare opportunity to hear from doctors who have lived through prostate cancer not only as medical professionals, but also as patients.
Moderated by Howard Wolinsky, the panel features Dr. Bruce Leslie, Dr. David Nash, Dr. Gil Solomon, Dr. Paul Schellhammer, and Dr. Michal Holub. Together, they explore what it feels like to move from the clinician’s side of the exam room to the patient’s side, and what that experience can teach men facing prostate cancer decisions of their own.
When Doctors Become Patients
A prostate cancer diagnosis can bring fear, uncertainty, and difficult decisions, even for physicians. Throughout this conversation, the panelists describe how medical knowledge helped them understand parts of their diagnosis, but did not remove the emotional weight of hearing the word cancer.
The speakers discuss their own experiences with PSA testing, MRI findings, prostate biopsy, second opinions, genomic testing, PSMA PET scans, treatment decisions, and ongoing monitoring. Several also describe the challenges of navigating medical systems, communicating with specialists, and deciding when to continue surveillance or consider treatment.
A central theme is the importance of shared decision-making. The panelists emphasize that patients should be informed, engaged, and willing to ask questions, while also working respectfully with their medical team.
What This Conversation Means for Active Surveillance
For men considering or living on Active Surveillance, this session highlights how complex prostate cancer decision-making can be. The discussion explores the value of careful monitoring, second opinions, pathology review, imaging, PSA density, and newer tools that may help clarify risk.
The panelists also speak openly about anxiety, uncertainty, and the need for support. Their stories show that Active Surveillance is not simply “doing nothing.” It requires attention, follow-up, communication, and a willingness to revisit decisions as new information becomes available.
Key takeaways include:
- Even doctors can feel overwhelmed when they become prostate cancer patients
- Second opinions can be an important part of prostate cancer decision-making
- Active Surveillance requires careful monitoring and ongoing communication
- PSA, MRI, biopsy, genomic testing, and PSA density should be considered together
- Shared decision-making works best when patients are informed and engaged
- Support groups and patient education can help men feel less alone
Watch the Discussion
Chapters
- 00:00 – Welcome, ASPI disclaimers, and meeting introductions
- 03:11 – Opening remarks on shared decision-making
- 07:02 – Program introduction: when doctors become patients
- 08:48 – Introducing the physician panel
- 10:49 – Dr. Bruce Leslie: uncertainty, second opinions, and shared decision-making
- 18:19 – Dr. David Nash: self-advocacy, biopsy slides, and AI-assisted pathology
- 27:25 – Dr. Gil Solomon: Active Surveillance, progression, and treatment decisions
- 41:35 – Dr. Paul Schellhammer: 25 years with prostate cancer and living with advanced disease
- 50:28 – Artera, ADT, and treatment-related testing
- 54:19 – Dr. Michal Holub: an international perspective from Prague
- 1:00:49 – Q&A begins
- 1:01:22 – Advice for newly diagnosed men
- 1:02:26 – Asking for a second opinion
- 1:05:36 – PSMA PET, genomic testing, and newer technologies
- 1:08:24 – Progression on Active Surveillance
- 1:09:32 – Whole-person health, lifestyle, vitamin D, and stress
- 1:13:14 – Testosterone and men on Active Surveillance
- 1:18:03 – PSA density and interpreting test results
- 1:20:45 – The value of local support groups
- 1:21:23 – Using AI tools carefully for patient education
- 1:27:25 – Closing remarks
About the Speakers
Dr. Bruce Leslie is an internist and nephrologist who has been on Active Surveillance since 2017. In this session, he discusses uncertainty, second opinions, physician communication, and the importance of finding doctors who are willing to engage in shared decision-making.
Dr. David Nash is an internist, health policy leader, author, and retired dean at Jefferson Medical College. He shares his experience with diagnosis, transperineal biopsy, AI-assisted pathology review, and the need for patients to speak up, ask questions, and stay engaged in their care.
Dr. Gil Solomon is a family physician and retired physician executive. His story includes diagnosis, Active Surveillance, signs of progression, treatment decisions, radiation, androgen deprivation therapy, and the challenge of applying medical knowledge to one’s own cancer journey.
Dr. Paul Schellhammer is a distinguished urologist, former president of the American Urological Association, and longtime leader in prostate cancer care. He brings the perspective of a physician who has lived with prostate cancer for decades, including advanced disease and multiple forms of treatment.
Dr. Michal Holub is an infectious disease specialist and university teacher from Prague. He shares an international perspective on Active Surveillance, anxiety, MRI monitoring, biopsy decisions, and the experience of being both a physician and a patient.
Learn More About Active Surveillance
- Read The Pathway: Your Guide to Active Surveillance, ASPI’s free guide for men considering or living on Active Surveillance.
- Explore ASPI’s Short Video Library for brief educational clips from past meetings.
- Watch more ASPI meeting recordings on Active Surveillance, prostate cancer decision-making, imaging, biopsy, treatment, and patient experience.
- Visit ASPI’s resources page for additional information and support.