Getting a second opinion is common, and several situations call for one. If you have concerns about your recommended treatment, a second opinion is appropriate. You should also consider getting a second opinion if the pathologist is having difficulty making a diagnosis, if you have been diagnosed with a rare type of cancer that your doctor is unfamiliar with, if you think your doctor underestimates the seriousness of your disease, or if your medical insurance plan requires it. For confirmation of your diagnosis, you can request a second review of your tissue slides, and for another opinion on treatment, a simple consultation with an expert may make you feel more comfortable. In some cases, a second opinion could correct a misdiagnosis or provide additional treatment options of which you may not be aware.

Find Referrals

Don’t worry about offending your doctor—most oncologists expect their patients to seek out second opinions. Many suggest it themselves and give recommendations for specialists who are recognized experts in diagnosing and treating specific types of cancer. Your treating physician should be open to discussion or confirmation of your treatment options with other doctors. If not, you may want to consider finding another physician.

Many local hospitals and regional cancer centers, such as Memorial Sloan-Kettering Cancer Center in New York City and M.D. Anderson Cancer Center in Houston, as well as institutions, including the National Cancer Institute and the National Comprehensive Cancer Network, have physician referral services that provide consultations for second opinions. An expert who specializes in your cancer can give you a different viewpoint, suggest clinical trials your doctor may not know about, or confirm your first doctor’s treatment recommendations. Nurse coordinators at large medical centers can be particularly helpful in finding physicians who give second opinions. Support groups and other cancer survivors may also be good sources for recommending oncologists and specialists.

You can also find experts through scientific journal articles. Doctors who have authored several articles on a particular cancer or treatment are considered experts and may be available for second opinions and consultations. Inquire about online or phone referrals, especially if you want a second opinion from an expert at a large cancer center or one who practices far from where you live.

Keep in mind that most of these consultations can be expensive and may not be covered by insurance.

View Graphic: Should I Get a Second Opinion?

Cover Your Bases

Before seeking a second opinion‚ you should obtain information about your disease, including diagnosis, staging, treatment options, and how recurrence might be prevented. Have your physician send your test results and imaging scans to the consulting doctor. You shouldn’t need to repeat any tests, but the second doctor may want to look over your medical tests to confirm the diagnosis.

For some insurance plans, second opinions are covered or even required before the plan approves payment for treatment. You may be limited to certain physicians or hospitals, so it is always best to consider your coverage plan when coordinating second opinion appointments.

Weigh Your Options

If the second doctor recommends a different treatment than your physician, which may be likely if your cancer does not have a set standard of therapy, you may become confused about what treatment advice you should take. For example‚ both surgery and radiation therapy may be suggested as options for a patient with early prostate cancer because both treatments have excellent long-term cure rates. But a urologist who specializes in prostate surgery might be more inclined to recommend surgery than a radiation oncologist. In that case, the decision may depend on how you weigh the side effects of each treatment with your own personal views and lifestyle. Your primary care doctor may also have helpful advice about weighing inconsistent recommendations.

Patients might also want to seek out a third opinion if they are still not comfortable with their diagnosis or treatment options. While it may not be necessary for your cancer to be treated by a specialist, sometimes it is helpful to get an opinion from one at a large cancer center or academic hospital, especially if your first two doctors recommend different therapies or have conflicting diagnosis results.

After you weigh your options, you must choose your medical team. Most patients go with their initial doctor, but the comfort level, treatment options proposed, and medical expertise should all be evaluated when making a decision.

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