Johns Hopkins Health Alert
Getting A Second Opinion
Prostate cancer is usually not an emergency. By taking your time, learning about your illness, and exploring your options, you're likely to make an informed decision that's right for you. And since doctors don't always agree on prostate cancer treatment, many men find it helpful to get a second opinion.
Although most people don't realize it, doctors don't always agree on the "best" treatment for early-stage prostate cancer. A recent study presented at the American Society for Clinical Oncology meeting found that men with early prostate cancer who consult only a urologist -- the doctor who performs radical prostatectomy -- are likely to choose that procedure. But men who see a urologist and a radiation oncologist are more likely to choose radiation therapy. This means it's wise to consult with a urologist and a radiation oncologist to get a clear understanding of your options. Health insurers generally pay for second opinions, and some even require them before certain procedures.
Getting a second opinion. You might be reluctant to suggest getting another opinion for fear of offending your doctor or thinking that he or she may not want to involve another physician. But many doctors welcome such discussions. If yours doesn't, strongly consider changing doctors.
Your primary care doctor and the urologist who performed your biopsy are the best sources for referrals. Request that, if possible, they suggest a colleague affiliated with a different hospital. Although this is not absolutely necessary, the practice is prudent because doctors who work at the same institution often share similar views and may not want to contradict one another. The American Medical Association (www.ama-assn.org) and the American Urological Association (www.urologyhealth.org) offer referral services.
Before your appointment. Check to be sure the doctor you consult is board-certified in the appropriate specialty. Ask your doctor's office to send a written summary and test results to the doctor you'll be consulting with. Call his or her office before your appointment to be sure the records have arrived as it will be impossible for your evaluation to take place without them.
At your consultation. Ask the doctor to explain why he or she is recommending a certain treatment, and take notes. Or bring a trusted family member or friend to help you remember the discussion, take notes, or ask questions you may have forgotten. Ask the consulting doctor to send a written report containing the recommendations to you and your referring physician.
Still not sure? If the specialists you see don't agree, schedule a consultation with a medical oncologist -- a cancer treatment specialist who does not perform radiation or surgery. Another option is to meet with a second urologist or radiation oncologist -- or both).
If you're having trouble making a decision, ask your primary care doctor -- or another specialist -- to help you sort through the options. Or, consider seeking an opinion at a nationally recognized cancer center, such as one that is affiliated with the National Comprehensive Cancer Network (www.nccn.org). It might also help to talk to men who have been treated for prostate cancer.
Posted in Prostate Disorders on July 2, 2009
Reviewed January 2011
Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer
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