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Recommendation for second opinion on prostate MRI scan?
Prostate Cancer | Last Active: Sep 27, 2023 | Replies (55)Comment receiving replies
Unfortunately more opinions do not usually make treatment decisions easier. Whatever urologist and team you are using you need to trust. If you switch teams, that may mean a delay in addressing the cancer.
I had a second mp-MRI shortly after the first. It was done in a different city and state with different equipment and pathologists that were considered more expert by the referring urologist and it found more cancer. The subsequent biopsy found higher grade cancer in that second location.
But as your urologist pointed out, you already have found actionable cancer that provides some clarity as to how you should proceed. It sounds like it may be time to move on without delay, as others have suggested.
Two options: If you're going to trust this urologist and team, get on with it! If you are not going to trust this urologist, find one you can trust quickly.
One certainty: Whatever we have going on cognitively and emotionally can be as much a factor in our treatment journeys as the medical evidence and treatment team. We all need to figure out how to address these challenges as we encounter them.
Replies to "Unfortunately more opinions do not usually make treatment decisions easier. Whatever urologist and team you are..."
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More opinions don't make treatment decisions any easier but in my case I believe it's necessary. I don't presume to advise what is right for someone else in different circumstances.
I'm 72. If I were younger, at higher risk, and had an aggressive case of prostate cancer then I would certainly feel pressure to "get on with it" as you say. Getting second opinions doesn't indicate a lack of trust. It's simply an acknowledgement that diagnostic tools and the personnel who use them aren't perfect. Dr. Mark Scholtz, founder of the Prostate Cancer Research Institute and double board certified medical oncologist has discussed the importance of second opinions and, more importantly, finding medical professionals who are experienced in interpreting prostate cancer biopsies and scans before seeking treatment.
I had three different Gleason scores on the same biopsy slides in one week from two pathologists (one of those pathologists downgraded his score). If that isn't cause for a few questions then I don't know what would be.
If my biopsy results from J. Hopkins are correct (Gleason 3+3) then treatment would not be recommended. In most cases, the biopsy is the most important diagnostic tool that we have. In my case, if the initial interpretation of my MRI is correct then the the results would be "discordant" to use the word of my urologist) with the interpretation of biopsy from Johns Hopkins.
In any event, my urologist indicated that I had a couple of months to think through my options and that's exactly what I'm doing.