Should You Get A Second Opinion In Your Cancer Care?
Obtaining a second opinion on your care is your right as a patient. Never feel guilty about asking for one. All physicians have had patients either come to them for a second opinion or have had patients obtain one elsewhere. If this upsets your physician, then they are not the right one for you. It is the job of your physician to help you achieve the best outcome possible, regardless of where and by whom.
If you think that getting a second opinion is not common, you should know that one report indicated that 56% of cancer patients obtain second opinions.(Hewitt, Breen, & Devesa, 1999)
If you have been diagnosed with cancer it is crucial that your diagnosis is correct, your treatment plan is appropriate and you are comfortable with the specialists on your cancer care team and what they are recommending.
Even though you may feel an urgency to begin treatment, in most circumstances, you have time to do your research and get additional opinions without negatively impacting the effectiveness of your treatment.
Since it can take up to a few weeks to get a second opinion, confirm with your oncology providers how much time you can delay while you obtain a second opinion. It’s important to recognize that even if you have already started treatment, it’s not too late to get a second opinion. In fact, you can obtain second opinions at any time point during your care (i.e. after your diagnosis, before your treatment, during your treatment, after your treatment.)
It’s not uncommon for treatment plans to change after a patient gets a second opinion. In a University of Michigan study of breast cancer patients, more than half of them changed their treatment after getting a second opinion from a multidisciplinary “tumor board” of medical oncologists, surgeons, radiation oncologists and pathologists.
You will need to let your physicians know that you are interested in obtaining a second opinion, as the second opinion team will require access to all of your pertinent records. Communication between providers is important so as to ensure that you get the most out of the second opinion. Records that are typically requested include:
Make sure to request all of your records as soon as you know you are going for a second opinion so there are no additional delays, and make copies for your personal file. I recommend carrying a copy of your records with you to any second opinions even if they request another set of copies be sent to them ahead of time, as they potentially could get lost.
You will need to sign ‘release forms’ to allow sharing of your confidential medical information with the second opinion providers. Some insurance plans may require a request for a second opinion from your primary care physician or a member of your cancer care team.
Many insurance providers, pay for second opinions.
So that there are no surprises, we recommend that you call them before you get a second opinion and ask. Often, insurance companies will only pay for providers in their network. Find out from them if there is a specific process they require you to follow to obtain this second opinion.
You have the right to appeal any denial for a second opinion, but you will need follow their appeal process. Keep records of all interactions (written, phone, emails, names, dates, etc.)
If the second opinion is the same as the first opinion, you will likely feel more reassured about the diagnosis, stage and treatment plan. At this point, you will need to decide which center or provider you will want to use for your treatment.
If there are differences in the two opinions, you have a few options on what to do next:
At the end of the day, you will need to make a final decision based on the different opinions, recommendations, programs and providers. If the opinions are all very different, it is very unlikely that there is only one right answer and you will have to make the best choice for you based on your circumstances and the information you have.
Don’t feel that you must get a second opinion. The vast majority of patients do not get second opinions if they trust their team and are in agreement with their diagnosis and treatment plan. You can always get a second opinion at a later date if you decide to do so.
Gooiker, G. A., van Gijn, W., Post, P. N., van de Velde, C. J., Tollenaar, R. A., & Wouters, M. W. (2010). A systematic review and meta-analysis of the volume-outcome relationship in the surgical treatment of breast cancer. Are breast cancer patients better of with a high volume provider? Eur J Surg Oncol, 36 Suppl 1, S27-35. doi: 10.1016/j.ejso.2010.06.024
Hewitt, M., Breen, N., & Devesa, S. (1999). Cancer prevalence and survivorship issues: analyses of the 1992 National Health Interview Survey. J Natl Cancer Inst, 91(17), 1480-1486.
Khazai, L., Middleton, L. P., Goktepe, N., Liu, B. T., & Sahin, A. A. (2015). Breast pathology second review identifies clinically significant discrepancies in over 10% of patients. J Surg Oncol, 111(2), 192-197. doi: 10.1002/jso.23788
Liu, C. J., Chou, Y. J., Teng, C. J., Lin, C. C., Lee, Y. T., Hu, Y. W., . . . Huang, N. (2015). Association of surgeon volume and hospital volume with the outcome of patients receiving definitive surgery for colorectal cancer: A nationwide population-based study. Cancer. doi: 10.1002/cncr.29356
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