Seeking a Second Opinion
A diagnosis of cancer can be scary, and understanding a treatment plan confusing. To gain more information, it is sometimes wise to seek a second opinion or advice from another qualified cancer specialist or group of specialists before or even after you begin treatment.
Getting a second opinion involves asking another cancer specialist or group of specialists to review your medical records and confirm your doctor’s diagnosis and treatment plan. Other specialists can confirm your pathology report and stage of cancer and might suggest changes or alternatives to the proposed treatment plan. They can also answer any additional questions you may have. There is often collective wisdom gained from the experience and opinions of different oncology specialists who are experts in your type of cancer.
There are lots of reasons for seeking a second opinion. Some doctors may favor one treatment approach, while others might suggest a different combination of treatments. Doctors in each oncology specialty bring different training and perspectives to cancer treatment planning. Another doctor’s opinion may change the diagnosis or reveal a treatment your first doctor was not aware of. You need to hear arguments for all of your treatment options. A second opinion is also a way to make sure your pathology diagnosis and staging are accurate, and that you are aware of clinical trials that you might want to consider.
If you are asked to consider alternatives, such as surgery, radiation, chemotherapy or hormone therapy, you might want to hear from each type of oncologist who provides that treatment. It’s all right to look at all your options; a second opinion could save your life or better protect your quality of life. Most doctors welcome another doctor’s opinion.
Second opinions are also valuable if you live in a small town or rural area where there may not be as many oncology specialists, especially if you have an uncommon type of cancer or might need a highly specialized or complicated type of care. If so, you may want to get an opinion from specialists at a larger medical center or comprehensive cancer center with particular expertise in treating your type of cancer.
Options for Getting a Second Opinion
Independent cancer specialist
Tumor boards and conferences
Independent Cancer Specialist
Often, your doctor can recommend an expert who could render an expert second opinion. You may also want to select a specialist on your own. A major regional cancer center or research-oriented hospital may be a good place to look for an independent source.
Tumor Boards or Conferences
Most hospitals and cancer centers have tumor boards or hold tumor conferences in which a group of cancer specialists — typically surgeons, medical oncologists and radiation oncologists along with pathologists and radiologists — meets to give a collective opinion on the best treatment for a cancer patient whose case is presented by a member of the group.
More likely than not, you were diagnosed with cancer based on a report from a pathologist who studied your tumor or a tumor specimen under a microscope to determine if the tumor was cancerous or not. There are many details about the characteristics of a tumor that comprise this report and that will influence both the stage of the cancer and your treatment plan.
So much of your treatment plan depends on the pathologist’s report that it sometimes makes sense to get a second opinion from another qualified pathologist, especially if there is difficulty or controversy in the pathology interpretation. Be sure to get a pathologist’s second opinion if the initial pathology report does not contain a definite diagnosis or if you have a very rare cancer or a cancer that has metastasized.
Some cancer specialists are the ultimate authority in specific treatments for specific cancers, such as a surgeon who operates on complicated tumors that other surgeons will not approach, or a medical oncologist with an experimental treatment that has been shown to be successful in preliminary studies but is still not widely offered (see Clinical Trials: Interpreting the Data).
Finding these experts is not always easy. Your doctor may know of an expert he or she can recommend. Cancer specialists from whom you seek a second opinion may also know of a renowned expert in treating your type of cancer. This is especially true if you have a rare tumor or an uncommon presentation of your cancer. This is a particular situation where getting expert help might be beneficial.
If you have access to a medical library in your area, you can try a computer search of medical journals for articles about your particular type of cancer or recommended treatment and find out which physicians have published their research about the disease and its treatment in these journals. A listing of medical libraries across the United States is available online from the National Library of Medicine at www.nlm.nih.gov/medlineplus/libraries.html.
Rate Your Doctor Sites
Dozens of Web sites (some listed as “Additional Sources” below) are available online that provide ratings of doctors in all fields of medicine by people who have actually seen or have been treated by the physicians. The sites allow patients to review their doctors and either praise or criticize their experiences. They operate much like online services that rate hotels and help consumers find plumbers who don’t overcharge.
Doctors may be listed by name, location, specialty and other search parameters. Many sites are free to use. Some rate hospitals as well. If you’re seeking a second opinion, you might want to check some of these sites out to find a specialist you are comfortable seeking advice from. But remember, the reviews are the opinions of patients or former patients and not ratings by health-care professionals.