Second Opinions

Bob and Queenie

People diagnosed with cancer sometimes ask me if their doctor will take offense if they get a second opinion.

The answer is no. Nearly all doctors today are receptive to patients getting second opinions. (And if you have one of those rare doctors that does take offense, you should seriously consider getting a new doctor).

Your doctors want you to be comfortable with the treatment decisions that are made. And they want you to feel comfortable with them as individuals. Treating cancer is often a life-long partnership between the two of you.

Second opinions are especially beneficial when there are significantly different treatment options available. For example, surgery, radiation therapy and "watchful waiting" are often reasonable options to consider for the treatment of prostate cancer. Talking with different types of physicians is often helpful.

Here are a few practical suggestions:

• It's entirely appropriate to ask your doctor for a recommendation as to where to go for a second opinion. This is especially true for rare cancers. You'll want a second opinion from someone who sees that particular type of cancer on a regular basis. In addition, your doctor's office can help arrange the appointment and send a copy of your medical records for you.
• You should ask your doctor how long you can safely wait before beginning treatment. Some cancers are relatively slow moving and a month's delay in beginning treatment won't make any difference. Other cancers are more aggressive and treatment should begin quickly. It's sometimes reasonable to obtain a second opinion even after treatment has started.
• You should generally obtain the second opinion from a physician who is not associated with your first physician. Physicians who work together tend to share similar philosophies and practice patterns.
• You may be able to obtain a second opinion without leaving town by arranging a telephone consultation. Major cancer centers are often able to provide opinions based on your medical records.
• We usually think of second opinions in terms of treatment decisions, but it's also possible to request a second opinion on the pathology itself. That is, your slides can be sent to another institution for a different pathologist to review.
• What should you do if your second opinion differs from the original recommendation? You can ask the two doctors to talk with each other to see if they can reach a consensus. You can seek a third opinion. Another option I recommend is to meet with your family doctor. He or she can often explain the options, place them in context, and help you reach a decision.
• My colleagues and I at the Cancer Resource Center also help people think through their treatment options. We don't provide advice, but we can listen without judgment and provide you with the opportunity to "think out-loud." Sometimes, what you really want is spinning around in your own head. We'll give you the space to sort it all out.

Bob is the Executive Director of the Cancer Resource Center. His articles about living with cancer appear regularly in the Ithaca Journal. He can be reached at [email protected].

Reprinted with Permission of the Ithaca Journal
Original Publication Date: March 13th, 2010