Before Treatment: Seeking a Second Opinion

March 28, 2013
CURE, Cancer Guide 2014, Volume 0, Issue 0

Why and how patients should get another opinion about their diagnosis and treatment

Every patient has the option to get a second opinion about any aspect of diagnosis or treatment. Whether there is concern about a recommended treatment or just a desire to hear the diagnosis confirmed from another physician, getting a second opinion is appropriate. Patients might also seek a second opinion if the pathologist is having difficulty making a diagnosis, if they have a rare type of cancer that their doctor is unfamiliar with, if they think their doctor underestimates the seriousness of their disease or if their medical insurance plan requires one. Patients can request a second review of their pathology slides or another opinion on treatment if their choices are numerous and they want reassurance they have chosen wisely. In some cases, a second opinion could clarify a diagnosis or provide treatment options about which they may not have been aware.

Find Referrals

Patients should seek a second opinion from a physician outside the same practice as their current doctor. They shouldn’t worry about offending their doctor—most oncologists expect patients to seek a second opinion. Some suggest it and offer recommendations. Many local hospitals and regional cancer centers, such as Memorial Sloan-Kettering Cancer Center in New York City (mskcc.org) and M.D. Anderson Cancer Center in Houston (mdanderson.org), as well as institutions, including the National Cancer Institute (cancer.gov) and the National Comprehensive Cancer Network (nccn.org), have physician referral services that provide consultations for second opinions.

Seeking a second opinion from an expert in the patient’s specific cancer can provide another viewpoint. Such an expert may suggest clinical trials the patient’s doctor may be unaware of or confirm a treatment recommendation. Support groups and other cancer survivors may also be good sources for recommending oncologists and specialists.

Cover All the Bases

Before seeking a second opinion‚ patients should obtain information about their disease, including diagnosis, staging, treatment options and how recurrence might be prevented. They should ask their physician to send test results and imaging scans to the consulting doctor. Patients may or may not need to repeat any tests, but the second doctor will want to look over existing tests or scans.

For some insurance plans, second opinions are covered or even required before the plan approves payment for treatment. Some plans limit coverage to certain physicians or hospitals, so it is always best for patients to consider their coverage plan when coordinating second-opinion appointments.

Weigh the Options

Some patients may get confused about what treatment advice to follow if the second doctor recommends a different treatment, which may be likely if their cancer does not have a set standard of therapy. 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. A urologist who specializes in prostate surgery might be more inclined to recommend surgery than a radiation oncologist would. In that case, the decision may depend on how the patient weighs the side effects of each treatment with his own personal views and lifestyle. A patient’s primary care physician may also have helpful advice about weighing inconsistent recommendations.

Patients might also want to seek a third opinion if they are still uncomfortable with their diagnosis or treatment options. While it may not be necessary for their cancer to be treated by a specialist, they may want to hear the opinion of someone who focuses only on their type of cancer, especially if their first two doctors recommended different therapies or had conflicting diagnosis results.

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