Although a vast majority of men who have been diagnosed with prostate cancer seek a second opinion before deciding on a course of treatment, second opinions are unlikely to change their treatment decisions, according to a recent U.S. study. The study, led by researchers at Johns Hopkins University, has found that second opinions did not change treatment choice or the person’s perception of the quality of care they receive, at least among low-risk men. Therefore, the value of these second opinions remains unknown. For this study researchers surveyed about 2,386 men who were newly diagnosed with localized prostate cancer in the Philadelphia area between 2012 and 2014.
The survey asked the men if they had opted for a second opinion from a urologist following their diagnosis of prostate cancer, and the reasons for the second opinion. About 40% of the respondents sought out second opinions, mostly, they said, because they needed to feel more informed about their cancer and options (50.8%), and because they wanted the best doctor possible (46.3%). Overall, second opinions were not found to be associated with choosing a definitive treatment (one aiming at a cure) or views of care quality.
“We were surprised by the relatively large percentage of men who obtain second opinions for their prostate cancer. We had thought that men who received second opinions, in general, may receive different treatment than men who did not. What we found was that overall, men who got second opinions had similar treatments to those who did not.”
Via Reuters Health-lead author Dr. Archana Radhakrishnan of Johns Hopkins University in Baltimore
The study also found that most men who obtained second opinions because they were unhappy with their initial urologist were 51% less likely to receive definitive treatment. And those wanting to learn more were 30% less likely to report “excellent” quality of care compared to men who did not seek a second opinion. In addition, about 80% 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.
“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.”
-Dr. Archana Radhakrishnan
Second opinions, the researchers said, represent more of a way of pursuing an original treatment plan with added support, than exploring treatment options. “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. The study has been published in the online journal Cancer.