Second Opinions for Cancer
Your doctor says you need treatment for cancer. Should you get a second opinion on your treatment options?
In many cases, the answer is yes. Whether you’re facing major surgery, chemotherapy, or radiation therapy, a second opinion can help ensure you’re getting the most targeted, effective treatment for your condition.
“At the very least, it’s an opportunity to feel more informed and secure,” according to Anthony L. Back, M.D., a Seattle oncologist. You can think of a second opinion as part of the learning process.
Because of the stress involved in a visit to a cancer doctor, people often hear only a portion of what they’re told, Dr. Back explains.
Even if the second doctor tells you the same information in a different way, you’ll be better equipped to manage your medications and other critical self-care. Equally important, you can be more confident in deciding between your treatment options.
When to seek a second opinion
“As an oncologist, I often say to people, ‘We usually have only one chance to cure you.’ Once cancer has recurred, the chance of a cure is much, much lower than the first time cancer is found,” says Dr. Back.
Many health insurance plans will cover a second opinion, and some require them for certain diagnoses. Check with your plan to be sure.
These are circumstances when a second opinion may be especially important:
You don’t trust your physician or the choice of treatment.
You’ve been given no hope for a cure.
The diagnosis is unclear.
Your situation is borderline; for example, the tumor is “nearly operable” or “nearly inoperable.”
The treatment is controversial or experimental.
You have a rare form of cancer.
Multiple treatments are recommended.
“Anytime the doctor talks about giving you a combination of treatments, such as chemotherapy, radiation and/or surgery, that should be a trigger for saying ‘Hmm … I think a second opinion would be worthwhile,’ ” explains Dr. Back.
Is it a surprise?
Another trigger is when you’re surprised by the doctor’s treatment choice, if only because you should feel confident as a partner in your care.
“When I’m treating people, I would rather have all their energy focused on working with me in taking medications and following other treatment advice, rather than on constantly wondering if it’s really worthwhile," Dr. Black says. "I want people to jump in and take care of themselves.”
A second doctor often will come to the same conclusion as the first one. Still, cancer doctors can vary widely in their approaches, experience, or knowledge of the latest treatments. One expert may notice something another one missed, or recommend a more aggressive treatment, an entirely different treatment, or no treatment at all.
Whom to consult?
If a second opinion is in your future, aim to consult someone who has at least the same level of expertise as the first doctor. Look for someone with a fresh perspective who’s in a different practice from the first physician. Ask the doctor how many patients with your condition he or she treats in a year. The higher the number, the better the likelihood this person really knows his or her stuff.
Hurry up and wait
Once you’ve made your choice, ask your current doctor to share your medical records, original X-rays, and test results with the referral doctor. After the consultation, if the second doctor’s advice confirms the first, you’ll have more confidence to proceed. But suppose the advice differs.
Feel free to say to the doctor, “This is quite different from what I heard from the other doctor. Can you explain why?” The second doctor should be able to give you a pretty convincing answer. You may want to discuss the different opinion with your first doctor.
Take the time necessary to understand all your options, Dr. Back advises. “Lots of people know they could get a second opinion, but feel they can’t take the time to do it because they should start their treatment right away,” he says.
That’s not true for most cancers. Occasionally, the situation demands that you really do have to drop everything and go to the hospital. But most of the time, the week or two needed for a second opinion will not affect the outcome adversely. In fact, it could improve it. And it will help you better understand what you’re getting into.
“Anxiety is a normal response to a cancer diagnosis,” adds Dr. Back. “But you shouldn’t treat your anxiety by jumping into treatment.”