Medical second opinions!

Have you ever gotten one, or do you go with your Doctors advice? Well I got a second opinion in 2005. Long story short, I was diagnosed with Prostate cancer by a Doctor in Frederick, she referref me to the Walsh group at Johns Hopkins, the Walsh group is world famous. The Doctor I saw gave me the usual poke and looked at my paperwork I had, he sat my wife and myself down and said in a tone I'll nver forget, "Tom, you have a nasty cancer", my first reaction was damn, I do? He said I'd have 3 probably 4 protocols, first hormone therapy, then radical surgery, then radiation, and after that probably chemo. A bleak outlook, I didn't believe him, how could he determine that with a simple rectal exam, my first Doc said nothing of the sort. As time came near for the hormone therapy to commence, my sister said "if I were you I'd get a second opinion", which I did, went to see a Doctor who was head of Washington Hospital Center Prostate surgery group. He sent me for an Endorectal MRI, a definite D ticket ride. The results came back 95% certain the cancer was contained. Was operated on a Wednesday morning, prostate removed, cancer gone, no spread, no pre or post op. anything. I was back here Monday morning feeling like Lazarus,had a tube and bag for 10 days that's it. I am not a Cancer suvivor, had some in my prostate, got rid of the prostate. So my advice to all of you, is in these kinds of serious matters get a second opinion, mine saved my way of life!

My reaction is what he meant by "You have a nasty cancer".  If that was simply based on paperwork, he may have been talking about the histology of the tumor, not how far it has spread (but, in a way, how far and how rapidly one can expect it might spread based on the appearance of the tumor tissue sample).  
 
Given the wide disagreement between the TWO opinions, might be time for a third because a lot of what the first doctor proposed may have been intended to prevent spread, not treat it, and once it has happened it is too late.  The fact that there was no evidence of the tumor spreading beyond the prostate at surgery is certainly good news, but possibly not all the information that is needed.
 
In any case, prostate cancer is very confusing since some cancers are deadly and some just sit there and likely will never hurt you. I recall a med school prof who said if all men lived to 90, all men would have prostate cancer.  It's that common in the very old and most never knew they had it.  So when one is found, deciding on which end of the deadliness spectrum it lies is not at all easy (or easy for the patient to understand).

You can read about my travails here - Strong Heart, Slacker Support. My decisions were fast but I had done my homework on the subject well in advance knowing the inevitable was coming. It was a question of stents or CABG. I took the tough route and didn't hesitate. Today I've never felt better for over 30 years. I'm active in Nordic walking and snowshoeing, lost weight, have low cholesterol, low blood pressure and was taken off meds last week by my cardiologist except for aspirin and the lowest dose of cholesterol drug possible. Of course I am getting older and have lost muscle strength. This last is probably the most frustrating in routine tasks like loading and porting kayaks, moving furniture, etc. The saddest day may come when I realize climbing stairs of a 6 level timber frame house I built will be too much. This is the house I built when I could deadlift 400 lb. timbers and clamber over the erected frame with ease 30 feet in the air.

My Dad was diagnosed with lung cancer by his longtime Doctor, and given 6 mo. to live. I suggested a 2nd opinion and he did just that.Long story short-he had a 3rd of his lung removed, no chemo necessary, and lived another 10 years cancer free. The Docter who gave the initial diagnosis was also the one who waved off my Dads complaints of a lower back ache as old age. 2 weeks later his aorta burst.He survived( only 2% of people do) I urge everyone to get 2nd opinions when it involves a serious medical condition.

^^^  Smart doctors don't predict lifespans.
 
But the human body is a funny thing.  If, during my active career, a patient had told me he had upper back pain, I never would have thought, "Oh, he must have an ulcer."  But I'm now almost certain that the pain I had in that location 10 days ago was caused by exactly that.
 
Any decent doctor knows that back pain can be caused by an aortic aneurysm but the odds of it being caused by that in an older man are very, very low.  In each case you have to decide, based mainly on anything unusual about it, whether to pursue the less usual causes (which can run up the bill a lot--and how often do we hear about expensive medical care blah, blah).  Among them, I might put cancer metastatic to the bone ahead of aneurysm if I were guessing, by the way.
 
On the other hand, the screening test  (an ultrasound) for an abdominal aneurysm is painless and fairly inexpensive, and it is now recommended for just about all male seniors.
 
One more thing--a repeat.  If you get 2 opinions and they don't agree much if at all, you probably need a third.  The one you like the least (that says you have a serious problem or need a radical treatment) could be correct.

I do not agree, BT,  lower back pain in an older man( he was 63 at the time) can very often be a sign of an aortic anueryism-and especially in recent years has come to light and has deemed incredibly preventable.And the norm age for these types of conditions range from 50-75 years of age. Not at all common in younger men, although there are exceptions.I researched this very deeply at the time it happened to my Dad.

BT


^^^  Smart doctors don't predict lifespans.

But the human body is a funny thing.  If, during my active career, a patient had told me he had upper back pain, I never would have thought, "Oh, he must have an ulcer."  But I'm now almost certain that the pain I had in that location 10 days ago was caused by exactly that.

Any decent doctor knows that back pain can be caused by an aortic aneurysm but the odds of it being caused by that in an older man are very, very low.  In each case you have to decide, based mainly on anything unusual about it, whether to pursue the less usual causes (which can run up the bill a lot--and how often do we hear about expensive medical care blah, blah).  Among them, I might put cancer metastatic to the bone ahead of aneurysm if I were guessing, by the way.

On the other hand, the screening test  (an ultrasound) for an abdominal aneurysm is painless and fairly inexpensive, and it is now recommended for just about all male seniors.

One more thing--a repeat.  If you get 2 opinions and they don't agree much if at all, you probably need a third.  The one you like the least (that says you have a serious problem or need a radical treatment) could be correct.

 
 
Very well said BT! I absolutely agree.