Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work
JUNE 28, 2017
This is a two blog day as I will be traveling most of tomorrow. First, thank you to Patricia who wrote to comment on the earlier entry about the possible benefits of Tai Chi. She commented that both she and her husband have found it helpful with balance issues, both those that naturally accompany aging and those related to other problems.
This second topic is the value of second opinions. My general advice is this: If you wonder whether you should get a second opinion, it is probably wise to do so. What you don't want is to be looking back several years from now and wishing that you had done so. On the other hand, most of the time (at least in Boston where we have an abundance of wonderful hospitals and doctors), the advice will be the same, and you will have expended some valuable time, energy, and money.
There may be times when a second opinion makes a lot of sense. One of those times is not when your friends or relatives are urging you to do so, but you are feeling comfortable and confident with your doctors. Your medical decisions and choices are for you to make. Reasonable times may include decisions about breast surgery, especially about reconstruction. It is my experience that different plastic surgeons may make different recommendations, presumably based partly on their own level of expertise and opinions. Remember in this case that plastic surgeons work closely with breast surgeons, so changing one may well require that you also change the other.
Second opinions may also make a lot of sense if you are in a gray area for additional treatment, chemotherapy or radiation. A risk of this situation is that you get differing pieces of advice, and then are forced to either see a third doctor/AKA tie-breaker or to make a tough choice. Seeing another physician can be helpful for people with metastatic cancer at moments of treatment change, perhaps especially if clinical trials are one of the options. Generally speaking, early cancers are treated the same way, so-called standard of care, by any good doctor. Treating advanced cancer becomes a balance of experience, knowledge, skill, opinion, art, and science. It is entirely possible that two fine oncologists will make two different recommendations.
As described in the article below, second opinions are mandatory if your first opinion is from a less than experienced or stellar doctor. Get yourself quickly to a cancer center or experienced medical oncologist or oncology surgeon.
A reminder: check with your insurance company about coverage for second opinions. It varies, and you want to know what to expect.
From the San Diego Times:
Second opinion not your first thought
by Doug Williams
Cindy Thomsen was 18 when her doctor told her she would die in three
months. He said there was nothing he could do. Thomsen, 60, grew up in
Lompoc and says the family’s regular OB-GYN at the time “didn’t have the
best bedside manner.” When he discovered the tumor on one of her ovaries,
he first didn’t explain to her parents it was malignant. Then, he decided
to call her to deliver the bad news while she was working at a
“He told me over the phone, as I’m taking orders, that I’m going to die in three months,” recalls Thomsen, a Santee resident. As soon as she talked to her parents, they were done with him.
“We’re going to get another opinion,” they said.
They took her to Los Angeles, where she received second and third medical opinions, had surgery to remove the ovary and then chemotherapy over 18 months. Forty-two years later, the cancer has never returned and she’s grateful her parents sought expert advice.
Thomsen’s experience was extreme, but, as she says, it points out the importance for patients to seek other points of view when diagnosed with life threatening illnesses or surgeries and serious treatments.
Yet seeking a second opinion isn’t a common inclination for most Americans. Seventy percent polled by Gallup in 2010 said they have confidence in their doctor and haven’t or wouldn’t seek a second opinion