Second Opinion Leads to Change In Prostate Cancer Diagnosis

Moyer Bunting prepared for Christmas 2018 from a dark emotional place. Just weeks before, he had been given the worst possible news: He had a rare form of prostate cancer that, even with treatment, would likely end his life within 3 years.

“I had talked with my family and my priest, and I was getting my affairs in order,” says Moyer, 68, of Lenexa, Kansas. “I had come to terms with it.”

Yet Moyer, a former healthcare executive who understands “the overwhelming maze” of diagnosis and treatment decisions, knew the importance of second opinions and self-advocacy in the medical realm. “I decided it would be wise to seek a second opinion, especially with something this serious. So, I set up an appointment at The University of Kansas Cancer Center,” he says. “In fact, when I called and explained my situation to the nurse navigator at the cancer center, she expedited my case to get me in as soon as possible.”

That call was perhaps the most important of Moyer’s life, and the one that ultimately resulted in the best Christmas gift he could have imagined.

A scary prostate cancer diagnosis

In 2012, Moyer learned he had bladder cancer. After successful treatment, he continued to monitor his bladder health with regular follow-up exams. During one such exam, Moyer’s surgeon discovered a bladder cancer recurrence and removed the malignancy. Several months later, the surgeon reexamined Moyer’s bladder to determine how well the treated area was healing.

“During that exam, the surgeon told me that he had also performed what he called a ‘partial TURP,’” Moyer says. The procedure, a transurethral resection of the prostate, is a common treatment for an enlarged prostate in which excess prostate tissue is removed. “When all the pathology results came back, he said he got all the bladder cancer out, which was good, but he told me that the reports showed I had ductal prostate cancer.”

Prostatic ductal carcinoma, the type of cancer Moyer’s surgeon identified based on pathology reports, is a rare and aggressive form of prostate cancer diagnosed in less than 1% of prostate cancer cases. It was September 2018, and Moyer’s surgeon was grave. “He said they could try to treat it, but I probably still only had 2 to 3 years to live. It was devastating,” Moyer recalls.

Moyer clearly remembers that difficult time. “I was a mess,” he says. “But I eventually got my head wrapped around what I assumed my destiny would be.” Something nagged at Moyer and Susan, his wife of 49 years, however. They agreed a second opinion was called for.

A multidisciplinary approach

Within a month of Moyer’s dire diagnosis, William Parker, MD, urologic surgeon at The University of Kansas Cancer Center, sat down with Moyer to discuss his case. “The original diagnosis for such a rare form of prostate cancer was a bit of a red flag, and Moyer’s explanation of his diagnosis left some unanswered questions that we needed to address,” Dr. Parker says.

At the cancer center, the region’s only National Cancer Institute-designated cancer center, physicians regularly meet to collaborate on patient cases. This collaborative group, known as a tumor board, draws upon the collective expertise of various specialists, creating a coordinated and individualized plan for each patient. Tumor boards exist across the cancer center’s many specialty fields, drawing upon current best practices and coordinated treatment regimens for multiple types of cancers.

This type of high-level collaboration between specialists in every aspect of cancer care sets The University of Kansas Cancer Center apart. Not only do specialists consult regularly on specific cases, they also bring research-based approaches to care to the table, including clinical trials when appropriate.

When Dr. Parker presented Moyer’s case to the tumor board, complete with all the records and reports from the initial diagnosis, the group agreed that additional data were needed. The pathology, when re-reviewed did not reveal any evidence of the rare subtype of prostate cancer originally diagnosed. New imaging exams indicated that Moyer had an approximately 30% chance of prostate cancer in the suspect region. “Based on the initial reports and the results we collected, we decided to repeat the biopsy. Our biopsy results showed no evidence of malignancy,” Dr. Parker says.

Second opinion means second chance

In many cases, a second opinion confirms an initial diagnosis. However, had Moyer not opted to seek a second opinion, his life now could be quite different. Moyer was prepared to have treatment and deal with end-of-life issues. He received a reprieve.

“It’s unusual for this kind of scenario to occur, but it certainly can. This is why it’s never a bad idea to seek a second opinion,” Dr. Parker says. He offers all patients an option to get a second opinion, and some take him up on it. Often, a gut instinct provides the impetus to double-check a diagnosis. “As physicians, we’re not offended when a patient seeks a second opinion,” he adds. “In fact, we respect that if something doesn’t seem right to a patient, they should get things checked out further.”

Moyer clearly remembers the phone call from Dr. Parker that replaced his despair with hope. “He called me personally and answered all of our questions,” he says. “He took time to really listen to us.”

While the news was a dream come true for Moyer and his family, it still took some time for reality to sink in. “I had spent a couple months coming to terms with everything,” he says. “I wondered if I needed a third opinion!” However, once Moyer processed all the information, he felt that the cancer center team had come to the right conclusion.

Moyer’s wife, Susan, agrees. “Dr. Parker called us a few days before Christmas, and what a gift he gave us,” she says. “We’re so thankful we sought out that second opinion. Why wouldn’t you, especially with something so serious?”

Looking ahead

Since receiving the news that he does not, in fact, have aggressive prostate cancer, Moyer and Susan are making the most of life. They enjoy travel and spending time with their 3 grandchildren. “I’m looking forward to my golden years,” Moyer says. “I’m just thankful for every day.”

With a career in healthcare administration and his own patient experience under his belt, Moyer reminds others to be active participants in their own care. “The most important thing is to advocate for yourself and take responsibility for your situation,” he says. “Your healthcare is driven by you, and getting a second opinion is part of that. I would tell anyone to do that, especially at a place like The University of Kansas Cancer Center where there are so many specialists working together.”