The Value of a Second Opinion

Started by anonymous, March 26, 2015
10 replies for this topic
anonymous

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Posted on
March 26, 2015
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.
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Mary Walsh

Member
0 Replies
Posted on
March 26, 2015
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.
Report
BillCurry

Member
0 Replies
Posted on
March 27, 2015
This is a fascinating post, not for what it says but for what it *doesn't* say. Fact: A "second" opinion reflects only the numerical order in which we cancerians get our medical advice. The fact that it's a "second" opinion doesn't ipso facto make it better than a "first" opinion. Getting a first opinion at Seattle Cancer Care Alliance and then getting a second opinion at a doc-in-the-box -- well, how much stock would you put in that second opinion? This post is vague on where all the "first" opinions came from, but it seems consistent that all of the "second" opinions came from highly regarded regional cancer research centers where doctors have deep knowledge in their expertise. In other words, if you're going to get a second opinion, go someplace better than the source of the first opinion. The fact is, *where* we get treated/counseled may be the most important decision we can make in navigating our treatments, not in the numerical order in which we get opinions. This point needs to be emphasized in boldface italics: Not all second opinions are created equal. *Where* the second opinion comes from is the key.
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Vick

Member
0 Replies
Posted on
April 02, 2015
Bill, I have a different view of the "where" issue. Like Mary, I've been diagnosed with multiple primary cancers (3 in the past 6 years). Most of my treatment has been at one of the highest rated cancer hospitals in the country. My CT scans showed evidence of lung cancer two years before any doctor reported it to me, and before I had learned how to access and read the radiology reports myself. Another time, I reviewed CT scans with my lung surgeon and he described the various nodules as essentially stable. We measured them on the screen together, comparing them to past scans. When the radiology report came out a week later it described one or two of these nodules as having grown significantly and the numbers were way out of line with what the doctor and I had looked at. I called the surgeon (yes I was scared) who pulled up the scans again and said essentially that the radiology report was wrong. Who knew such a thing could happen? So my view now is that even within the best hospitals or when being followed by the "best" doctors, mistakes happen, oversights are made. When it's cancer, and your life is at stake, having more than one professional look at your case is a great idea. For advanced disease that doesn't have a standard of care, then perhaps treatment advice would change. But I've learned to my surprise that interpreting scans isn't a black/white affair, and for me, the more knowledgeable eyes on those the better.
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Infinity

Member
0 Replies
Posted on
April 02, 2015
I agree with the second opinion theory.
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Mary Walsh

Member
0 Replies
Posted on
April 07, 2015
I agree, Bill, that who does the second opinion matters. In certain situations, perhaps even another second opinion in another cancer facility might be of value. All radiologists are not created equal.
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BillCurry

Member
0 Replies
Posted on
April 07, 2015
I rest my case. It isn't the ordinal *number* of the opinion that counts, it's *who,* as you say, offers the opinion, and that basically comes down to where. My fear is in sanctifying Second Opinions as somehow *better" than first opinions, when the only thing that's true is the order in which we received the opinions. Who and where opinions come from matter more than the order in which they come. Anybody had a cancer-fighting coffee enema from Dr. Gerson lately?
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Mary Walsh

Member
0 Replies
Posted on
April 08, 2015
You are funny! I had a friend who went for four opinions, but that was silly, I think.
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BillCurry

Member
0 Replies
Posted on
April 08, 2015
FOUR? Silly, indeed. Keep up the good work -- and kick your cancer's butt! Big hug of support to you, Mary -- B
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secondopinions

Member
0 Replies
Posted on
May 14, 2015
A person’s health is too important not get a second opinion. Statistics show that medical errors are now considered to be a third leading cause of death and up to 400K people die a year as a result. Additionally, many surgeries and procedures performed are not indicated and can be avoided. A second opinion can help reduce the risk of being affected by a medical error and can help avoid a dangerous surgery or procedure. I recently found this great site https://secondopinions.com which provides second opinions for all areas of medicine and interpret all kinds of imaging studies such us MRIs, CTs, X-Rays. When I needed a second opinion last month, Secondopinions.com provided a fairly priced service to me that helped keep me from becoming a statistic. They have also been on the news throughout the country. Please watch this recently aired TV News segments featuring SecondOpinions.com which address medical errors and emphasize the importance of obtaining second opinions: https://secondopinions.com/mediaroom/television-interviews.html.
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richardabreu

Member
0 Replies
Posted on
June 09, 2015
I believe that we have the right to doubt of some medical examinations, and we should be able to have some sort of verification or someone else's opinion to bolster our final decision. I was looking for a solution to this problem and I found this company that provides a "second opinion." It is ironic since the name of the company is Second Opinions. I contacted the company and they gave me a 15% discount with the code "wellness". The code is available to everybody. I am satisifed with the results. The website is secondopinions.com
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