Health Team

Duke Clinic Puts Value on Getting Multiple Opinions

Posted July 5, 2007
Updated July 7, 2007

— Most men diagnosed with prostate cancer depend heavily on a doctor's advice, but a recent study showed that advice may differ depending on the type of specialist you see. A newer approach leaves a specialist's bias out of the equation.

Today, Randall Blanco's diet and lifestyle focus on cancer prevention. Fifty years of age is when most men begin full prostate cancer screening with a PSA blood test along with annual digital rectal exams. Health experts said African-American men should begin at age 40.

Early last year, Blanco learned he had prostate cancer at 39.

"I was not ready to hear that I had prostate cancer," he said. "I was not ready to hear the different options."

Those options include surgery, different forms of radiation, chemotherapy, hormone therapy, experimental treatments or a watch-and-wait approach called "active surveillance." Health experts said all treatments have benefits and potential side effects.

So which treatment is best? According to a study by the American Society of Oncologists, most patients tend to choose the treatment offered by the first specialist they see, even though other treatment options may work just as well or even better for that patient.

"That study really underscores the importance of meeting with multiple providers," said Dr. Phillip Febbo, an oncologist at Duke Medical Center.

At Duke's multidisciplinary clinic for prostate patients, a urologist, medical oncologist and radiation oncologist are involved with each case. One doctor meets with the patient first, then all three doctors discuss the case. They form a consensus opinion, based on the patient's age and the aggressiveness of the cancer.

"Our job is to try and help patients arrive at a choice based on their own priorities and needs and the particular disease that they have," said Dr. Robert Lee, a radiation oncologist at Duke.

Still, the ultimate decision lies with the patient.

"Our goal is not to tell them what to do, but it is to help guide them through that process," said Dr. Stephen Freedland, a Duke urologist.

Blanco chose surgery to remove his prostate back in February 2006.

"By now, I feel like I am back to the same function level that I had just before surgery," said Blanco.

Blanco said he considers it a great blessing that his early cancer detection gave him the luxury of having many good treatment choices.


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  • Historians 12th Jul 6, 2007

    Oh "Multiple Opinions," I thought I saw something else oh well that takes care that joke. Better luck next time.

  • thecatsmeow67 Jul 6, 2007

    It can, but it has to be a team effort to get the Multi-D idea off the ground, it took us a year to get that clinic going like it should be. A cancer pt. needs to check w/ his/her MD to see if there is a multi-D approach to that particular disease. We lovingly call our Multi-D clinic "one-stop shopping" you make one trip and get three opinions, go home and think about what you ( the patient) wants to do and call the MD of your choice and make plans from that point.

  • Scarecrow Cow Jul 5, 2007

    I wonder if a team approach might help people with other types of cancer decide which treatment option is best for them.