Prostate Cancer Second Opinions: Alternate Advice Might Not Force Treatment Change

Prostate cancer patients seeking second opinions shouldn’t always expect a change in treatment. That’s the revelation of a recent study on the disease and what’s in it for patients looking or advice from alternate sources aside from their usual doctor.

According to a report on the study from DotMed, cancer organizations in general are largely in favor of second opinions. This is in order for patients to have a clear understanding of their disease and to be educated about their treatment options. As cancer management options may run the gamut from surgery to active surveillance to radiation therapy, the researchers believe this is the reason why support organizations believe it’s a worthwhile decision to get a second opinion.

Aside from analyzing the impact of second opinions, the study, which was led by Johns Hopkins University researcher Dr. Archana Radhakrishnan, looked at the reasons why patients with prostate cancer may want a second opinion from another doctor. And based on the researchers’ findings, patients suffering from a localized form of the disease generally sought additional opinions regardless whether they needed a change in treatment or weren’t satisfied with the quality of cancer care.

Furthermore, the study found that second opinions were irrelevant in relation to treatment regimens for men classified as low-risk.

From 2012 through 2014, the researchers looked at close to 2,400 men from the greater Philadelphia area suffering from localized prostate cancer. Second opinions were sought by approximately 40 percent of the subjects, and out of these men, close to 51 percent said they did so to get more information about their disease. About 46 percent said that they wanted the “best doctor” possible to be treating them for their condition.

The researchers concluded that second opinions had no associative link to the perceived quality of care or a desire to get definitive treatment.

“Men who sought second opinions because they were dissatisfied with their initial urologist were less likely to receive definitive treatment, and men who wanted more information about treatment were less likely to report excellent quality of cancer care compared with men who did not receive a second opinion.”

When it comes to curing prostate cancer, patients have multiple options. According to a blog post from Medical Daily, not all these options may be appropriate for every patient, and active surveillance may be the best tool to use for “many” men who suffer from the disease. But in the end, each option has its share of advantages and disadvantages.

“Taken as a whole, there is no difference in the likelihood of cure whether one has surgery or radiation therapy. If one method of treatment were clearly superior, it would make life easy. We as physicians would just tell everyone to have that treatment. Since cure rates are equivalent, however, men have to consider their options and decide which treatment they want.”

Indeed, it can be quite difficult to choose the best form of treatment for prostate cancer, second opinions or none. The DotMed report cited a separate, randomized study led by Dr. Freddie Hamdy of the University of Oxford, where the researchers discovered that mortality rates for the disease were “low irrespective of the treatment assigned,” with no marked differences among the different options patients have. The study noted that death rates were close to the one percent range for all forms of treatment.

Dr. Mark Litwin, chair of urology at UCLA’s David Geffen School of Medicine, was not involved in either study, but had some interesting thoughts on how men with prostate cancer should go about second opinions, particularly if it is to look for a higher-end treatment regimen.

“Virtually no one had died from prostate cancer. All three groups have almost 100 percent surviving. That should give all men pause before pursuing radical treatment for low- or intermediate-risk tumors.”

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