Getting a Second Opinion

A second opinion can provide answers, ideas and perspective about whether a patient is on the right treatment path.
Cindy Walker is grateful that she sought a second opinion after being told she’d experienced a recurrence of ovarian cancer.

Without the second doctor’s insights, she would never have known she could consider chemotherapy.

It was after an eight-year remission that the Davis, Calif. resident learned that cancer had recurred in her lungs and lymph nodes. Her small local hospital diagnosed the tumors as a type of ovarian cancer called borderline serous—the same as her original diagnosis.

But when Walker sought a second pathology opinion from a major university medical center, experts there concluded that the new cancer in her lungs was not borderline. Instead, it was low-grade ovarian cancer.

It’s a critical distinction, Walker says. “Low-grade ovarian cancer has a low chemo response rate, but borderline tumors have a zero response rate. Before taking the risks involved with chemo, I must be certain what condition I have.”

As of late December 2014 she was not yet receiving treatment, but planned, when the time was right, to “seek a tiebreaker third pathology opinion.” A second opinion may validate what a patient has already been told, answer lingering doubts and questions, or even change the course of treatment. Second opinions are especially valuable if someone has a rare cancer, if cancer progresses during treatment, if the doctor recommends a new treatment, and upon treatment completion. Second opinions are also warranted if a doctor tells a patient there is no lifesaving treatment available.

“Patients should be looking for a comprehensive evaluation of their options,” says Patricia Thompson, a medical oncologist at Cancer Treatment Centers of America at Southeastern Regional Medical Center in Georgia.


A second opinion is a good idea if a patient is uneasy with a doctor’s approach. “Listen to your gut,” says breast cancer survivor Angil Tarach-Ritchey, a registered nurse who lives in Michigan. “If any part of you is uncomfortable with the initial diagnosis, treatment plan or the physician, get a second opinion. If you have anything less than full trust in your physician’s knowledge, skills and bedside manner, you will not receive optimal treatment because there will be a barrier between you.”

[Read "When a Second Opinion is One Too Many"]

Raina Pepke, of South Pasadena in Southern California, sought a second opinion when she realized that her first medical oncologist had very little experience with her kind of cancer. “Once I had a chance to read through some journal articles, I quickly became aware that he wasn’t on top of the latest research,” she says.

She traveled to Stanford University to consult with an ovarian cancer specialist, who clearly and comprehensively explained her options and recommended a local medical oncologist who could continue her care.

Donna Heckler was initially advised to have immediate surgery for her breast cancer, but a second opinion convinced her to have chemotherapy first. She is now four years post-diagnosis. Photo by David Torrence.


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