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 Prostate cancer management options range from surgery and radiation
to “watchful waiting.” Most men with prostate cancer are over age 65
and do not die from the disease, so treatment may not improve health
or lengthen life in all cases, according to the Centers for Disease
Control and Prevention.
“We were surprised by the relatively large percentage of men who
obtain second opinions for their prostate cancer,” said lead author
Dr. Archana Radhakrishnan of Johns Hopkins University in Baltimore.
“We had thought that men who received second opinions, in general,
may receive different treatment than men who did not,” she told
Reuters Health by email. “What we found was that overall, men who
got second opinions had similar treatments to those who did not.”
The researchers surveyed about 2,000 men who were newly diagnosed
with localized prostate cancer in the Philadelphia area between 2012
and 2014. Forty percent sought a second opinion after diagnosis,
often to get more information about the cancer. Only 20 percent of
men who sought another opinion said they were not satisfied with
their first doctor.
About 80 percent of the men received definitive treatment, including
surgery or radiation. Those who sought a second opinion were no more
or less likely to get definitive treatment.
“It is evident here and in other studies that people seek second
opinions for a variety of different reasons, not all about looking
for a different doctor who will offer different treatments,” said
professor Jenny Philip of St. Vincent’s Hospital Melbourne in
Australia, who was not part of the new study. “The need for
reassurance, the need to be sure of having all the information and
provided in a way that is understood may all be a means of
confirming the approach suggested by the first doctor.”
The men also rated the quality of their cancer care on a scale of
one to five, and responses were similar regardless of having a
second opinion, according to the report published in the journal
Cancer.
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“The results tell us that we need to investigate the motivation for
men receiving second opinions to better understand how they may
relate to treatment decisions,” Radhakrishnan said.
“For example, men who said they got a second opinion because they
wanted more information, wanted treatment from the best doctor or
because their friends and family were encouraging them to get
treatment were more likely to get surgery,” she said.
Patients must understand their disease and the options that are
available to them before making treatment decisions, she said.
Even if treatment decisions do not change, second opinions can be a
useful and important exercise, Philip said. But second opinions
require clinical and financial resources that some areas may not
support, she said.
“To the extent that second opinions help patients and their loved
ones become more informed and feel more comfortable with their
decisions, then second opinions can be important - even if they
don’t end up changing patterns of treatment,” Radhakrishnan said.
SOURCE: http://bit.ly/2eJqnZN Cancer, online November 7, 2016.
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