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Second Opinions

Posted 10/24/2009

Posted in

I have written about this before, but considering a second opinion is often an issue for women at various points in the cancer experience. There are two times when it especially seems relevant: around diagnosis if there are choices about treatment (e.g. whether or not to include chemotherapy or whether to try to achieve clean margins surgically after one or two wide excisions) and during treatment for Stage IV disease when a particular drug stops working.

We are very fortunate in Boston to have many wonderful doctors and world-class hospitals. Yes, it is possible (and easier in some ways) to get a second opinion at the hospital where you already are. And it is also reasonable to go to another institution for this appointment. My bottom line is this: No good doctor objects to your consulting with another specialist and if you are wondering if you should have a second opinion, you should do so. You don't want to later regret not talking with someone else.

Here is a good summary from ASCO's Cancer Net:

Home > All About Cancer > Newly Diagnosed > Find an Oncologist > Seeking a Second Opinion

Seeking a Second Opinion

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/09

Listen to the Cancer.Net Podcast: Seeking a Second Opinion, adapted from this content.

Cancer can be a confusing and frightening diagnosis, and it is hard to make decisions about possible treatment. Because treatments are continually improving and it is important to find someone with experience in treating your type of cancer, it may be valuable to seek the knowledge and advice of more than one doctor. This is called a second opinion. A second opinion is helpful when a doctor suspects or diagnoses cancer, or recommends a specific treatment plan. Asking for a second opinion is common practice. The more knowledge you have about a particular diagnosis and the treatment options available, the more comfortable you will be regarding the health care decisions you will make.

A second opinion after diagnosis

  • A second opinion after the diagnosis can provide a great deal of information.
  • Get confirmation of a cancer diagnosis
  • Obtain additional detail on the type and stage of cancer
  • Refute a diagnosis of cancer, so you can avoid unnecessary treatment

A second opinion before treatment

  • Seeking a second opinion before beginning treatment can also provide a great deal of information.
  • More information on the type of cancer, especially if the cancer is rare and knowledge is limited about the particular cancer or treatment.
  • Access to recognized experts and specialists (such as radiologists or surgeons) who may have treated other patients with this cancer. Find a local cancer center or cooperative group.
  • More access to potentially promising new treatments not yet available to the public through participation in clinical trials, especially if the doctor providing a second opinion is affiliated with a major cancer center

Paying for a second opinion

Most insurance companies and health maintenance organizations (HMOs) pay for a second opinion when cancer is suspected or diagnosed. However, it's recommended that you ask about payment before seeking one. Be sure to also ask you're required to select from a specific group of doctors when seeking a second opinion. Some insurers even require a second opinion before they will pay for cancer treatment.

Finding a doctor for a second opinion

Let your doctor know if you wish to seek a second opinion. Most doctors fully understand the value of a second opinion and are not offended when patients seek one. They may even be able to suggest another doctor. If you need an oncologist in your area to consult for a second opinion, try searching the Find an Oncologist database, which includes ASCO members in the United States and abroad who have made their contact information public.

In some cases, seeking a second opinion from a specialist is very helpful, as there are many different types of oncologists. Other possible sources for finding a doctor are:

  • Local hospitals, medical clinics, or cancer centers
  • Medical schools and medical associations
  • Friends and family
  • Patient information or support organizations

Once you locate a possible doctor for a second opinion, ask about the doctor's area of specialty and credentials, such as board certification, training, and experience, and bring all relevant medical records, including test results, x-rays, and any related materials to the appointment. Often, the doctor providing a second opinion will request the results of any tests or procedures you have already had performed, eliminating much of the need for repeat testing. It may also help to bring a notebook to the appointment to write down the doctor's recommendations.

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