The Value of a Second Opinion

Cancer #1: the breast. After the lumpectomy to treat the HER-2 positive cancer, my sister Anne suggested I go for a second opinion about the treatment. I admire my sister, who uses her knowledge to help others, and who was working at Cornell doing cancer research at the time.

Knowing nothing about cancer treatment, I had already been referred to an oncologist, Dr. A, by the surgeon, who in turn had been referred by my gynecologist of 30 years. I liked the way Dr. A talked: about being aggressive with treatment, and that he and my internist, Dr. L, would be “following me like a hawk” for the next five years. After I heard Anne’s suggestion, I felt a little odd, as though going for a second opinion meant I didn’t trust Dr. A. However, she assured me that “everyone expects there will be a second opinion.” The doctor I went to at Cornell had been doing breast cancer research for 35 years. I was pleased to receive a prescription from her with the same treatment that Dr. A had prescribed. Rather than questioning his capability, this had the effect of increasing my trust in him.

Six years after the breast cancer had been discovered, it was time for a routine colonoscopy. I called Dr. L’s office and suggested, “Can’t I just have one of those stool kits?”

“He’s not going to buy that,” replied the nurse. Good thing, because Cancer #2 appeared during the colonoscopy. After the colectomy, and because of my strong relationship with Dr. A, I said to Anne, “I don’t think I’m going to go for a second opinion.”

“You have to,” she said. This time I went to Memorial Sloan Kettering to see a gastroenterological oncologist, Dr. V. Again, her recommendation for treatment matched the one I had already gotten from Dr. A. I wasn’t surprised by that, but I was surprised a month later when she contacted me by phone.

Before our appointment, Dr. V had requested the CT scan that had been done before the colon surgery, along with the pathology slides from that operation.

“Our radiologist was looking at the CT scan and noticed that one ovary was bigger than the other,” she said. “I suggest you go for an ultrasound,” which I did. A month later I was back on the operating table, this time for a complete hysterectomy. That was Cancer #3, not full-blown, but “serous borderline tumors.”

After that operation, I didn’t need any encouragement to go for another second opinion, this time to a gynecological oncologist at Memorial Sloan Kettering. That doctor agreed with Dr. A about the treatment, but then she noted, “Our radiologist picked up a small nodule in the lung.”

“Could you please discuss it with Dr. A, my oncologist?” I asked, and she did.

They worked out a plan for CT scans every three months. Come January, 2015, Cancer #4 was confirmed in the lung.

You can see why I think that any kind of important disease deserves a second opinion.