Patient advocacy can change lives.
It’s not unusual that I am called upon to advise the recipient of a devastating diagnosis on seeking a second medical opinion. Some 56% of all patients obtain a second opinion following a diagnosis, and they are right to do so, replacing feelings of betraying their physician with confidence in being proactive and leaving no health-related stone unturned. The reasons that patients seek second opinions are varied, and justified.
Is the initial diagnosis correct?
If the patient’s initial pathology is read incorrectly, the plan of treatment is altered dramatically, and once radiation and chemotherapy treatments begin or surgeries are performed, they can’t be undone. One study reports that 11% of breast cancer pathology second opinions resulted in differences that changed treatment recommendations.
Is the recommended treatment appropriate?
It is quite common for specialists to read your report and recommend a completely different approach to your initial treatment regimen, dosage, duration, procedures and aftercare. Some may discuss clinical trial options, while others will not. If members of your care team are not experts in your specific cancer, you may benefit from a second opinion with an individual who specializes in your form of disease, especially if it is rare, as studies show that physicians who deal more frequently with rare cancers often produce better outcomes.
I am uncertain about my diagnosis, and am not entirely comfortable with my current medical care team.
Some patients simply feel rushed, as if they’re not getting the attention warranted at this trying time, or they don’t understand the diagnosis or terminology fully. When seeking a second opinion, find a doctor who is not only willing to take the time to help you understand your diagnosis and prognosis, but also one who is not affiliated with your current provider — someone who is not in the same practice, hospital, medical school or community. Also, avoid defaulting to the large, well-known cancer centers merely because you recognize their name. Sometimes they are a great fit, but they just might not be right for you.
What’s most important is to find an individual specialist, rather than an institutional name.
Is there more that can be done?
Some patients have been told they have numerous options for treatment and that decisions need to be made quickly in order to begin a cancer-fighting regimen. Others wonder if there are treatment options that are not being communicated. If you are interested in incorporating integrative oncology into your team, choose a physician who has expertise in your specific disease and is a member of the Society of Integrative Oncology. If you would like to incorporate naturopathic care, find a practitioner who is fellowship trained and is listed with the Oncology Association of Naturopathic Physicians. More information on both integrative oncology and naturopathic care can be found by visiting these comprehensive sites:
I have been told that my disease is incurable.
Although all diagnoses are frightening, some patients are truly facing a bleak future. They have been advised that treatment will be ineffective after a short time or will debilitate the patient with side effects due to high toxicity. Seeking a second opinion may bring hope, as studies show that a higher trust in your medical team is associated with more beneficial health behaviors, less symptoms, higher quality of life and more satisfaction with treatment.
The time and research invested in seeking the best treatment option is invaluable.
And when you’re doing homework and setting appointments, keep in mind that communication is key: If you have a meeting for a second medical opinion, make sure that all involved providers (and you!) have copies of your most recent radiology reports, pathology specimens and reports and the consultation and office encounter notes from your current cancer care team. Your current provider should not only encourage you to seek alternate assessments, but provide information to set you on the path of the best possible outcome. As a proponent of patient advocacy, I often counsel patients on where to go for a second, or even a third, opinion, culminating in what could be the first step in fighting fear and feeling hopeful.