How to change prostate cancer treatment

Though many men diagnosed with prostate cancer seek a second opinion before beginning treatment, second opinions are unlikely to change their treatment decisions, according to a U.S. study.

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.”