Health Team

Duke Clinic Puts Value on Getting Multiple Opinions

Most men diagnosed with prostate cancer depend heavily on one 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.

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DURHAM, N.C. — 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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