Advanced prostate cancer: should you seek a second opinion?

If you are living with advanced prostate cancer, you may consider getting a second opinion. A second opinion is when a person with a diagnosis seeks out a healthcare provider other than the healthcare provider that they are currently working with. The new healthcare provider will usually begin by reviewing test results and medical records. Based on that review, they will give an opinion on the diagnosis, treatment recommendations, and next steps.

Second opinions and advanced prostate cancer

Advanced prostate cancer refers to cancer that began in the prostate but has spread beyond the prostate to lymph nodes, other organs, or bones. Advanced prostate cancer is not curable, and the goals of treatment are to slow the progression of cancer, manage symptoms, and help a person maintain a good quality of life.

Treating prostate cancer at any stage involves weighing the benefits of a particular therapy against the adverse side effects that therapy can cause. Surgical removal of the prostate, radiation therapy, and androgen deprivation therapy can all be effective treatments for prostate cancer—but can also impair quality of life:

• Surgery. Surgical removal of the prostate is often used to treat early-stage prostate cancer. It is also sometimes used to treat advanced stage prostate cancer in certain cases. Side effects include urinary incontinence and sexual dysfunction (including impotence).
• Radiation therapy. Several different methods of radiation therapy can be used at different stages of prostate cancer, including advanced prostate cancer. Side effects can include bowel problems, urinary incontinence, and sexual dysfunction.
• Androgen deprivation therapy (ADT). Also called hormone therapy, this approach reduces the levels of male sex hormones. ADT can also cause side effects that include impotence, hot flashes, the shrinking of male sex organs, loss of muscle mass, weight gain, fatigue, and depression.

It can be difficult to look at this list of side effects and make a decision about treatment. When making a decision, you’ll want to have as much information as possible. You’ll also want to feel confident that you are making the best decision for you.

Seeking a second opinion can provide you with more information and help you make treatment decisions with more confidence.

Other reasons to get a second opinion

Feeling confident in your treatment decisions is important when living with advanced prostate cancer. But there are other reasons to seek a second opinion as well. Examples include:

• You have a rare form of prostate cancer.
• You do not fully understand your diagnosis or want a different explanation of your diagnosis.
• Your healthcare providers are uncertain about your diagnosis—for example the stage of the cancer.
• You have a difficult time communicating with your current healthcare providers.
• You do not feel like your concerns are being taken seriously.
• You are having trouble choosing between treatment options.
• You want to explore treatment options that are not offered at the medical center where you are currently being treated, or you want to talk to providers who specialize in newer types of treatment.
• Your friends and loved ones think you should seek a second opinion.
• People you have spoken to at support groups for prostate cancer recommend getting a second opinion.

Even if none of these reasons resonate with you, here is another—advanced prostate cancer is a complex disease, and no two cases are the same. Taking an active role in your treatment means learning as much as you can about your diagnosis. Your best source of information will be healthcare providers who have expertise and experience in the treatment of prostate cancer.

How to get a second opinion for advanced prostate cancer

If you’ve decided to seek a second opinion for advanced prostate cancer, your next step will be finding a healthcare provider.

• A good place to start is by talking to your current healthcare team. Your oncologist or oncology social worker may be able to give you a list of other providers to contact.
• You can also search for a different healthcare provider through your health insurance company.
• Friends, family members, and support groups for people with prostate cancer can also be a source of recommendations when looking for a provider.
• You’ll need copies of test results, medical records, and any treatments you’ve been prescribed. Your current healthcare team can provide this information.
• Prepare for your appointment by making a list of concerns, questions, and topics you want to discuss with the healthcare provider where you are getting a second opinion.

How will your oncologist feel about a second opinion?

Obviously, you want to have a good working relationship with your oncology team. If you’re considering a second opinion, you may wonder if your current oncology team will be offended. Know that this should not be a concern. Second opinions are a common practice. Second opinions can also be valuable to your current healthcare team, whose goal is to provide you with the best care possible.