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Being diagnosed with cancer can come as a shock. But it can be even more troubling if a patient suspects that their initial diagnosis or treatment recommendation might not be entirely accurate or would like to learn about different treatment options.
In medicine, a second opinion involves getting the opinion of a doctor other than the patient’s current doctor. The second doctor may confirm the first doctor’s assessment, or they may question the initial diagnosis or offer other treatment recommendations.
Even if a patient trusts their first doctor’s opinion, it’s often a good idea to seek a second opinion to confirm the diagnosis and ensure that they are able to pursue any and all treatment options available. For instance, a 2018 study published in the Annals of Surgical Oncology found that a second review by a multidisciplinary tumor board at a National Cancer Institute-designated cancer center (such as the University of Colorado Cancer Center) changed the diagnosis for 43% of the 70 breast cancer patients in the study, including 16 patients who were diagnosed with additional cancers not detected by their original doctors.
When facing a cancer diagnosis, it’s normal to wonder whether another doctor could offer more information or different treatment options. As the only National Cancer Institute Designated Comprehensive Cancer Center in the state of Colorado and one of only four in the Rocky Mountain region, the University of Colorado Cancer Center has doctors who can look at test results, talk with patients about their personal situation, and offer second opinions on cancer diagnoses and treatment plants. CU Cancer Center doctors have experience and expertise in treating numerous types of cancer, and cancer researchers are dedicated to diagnostic and treatment innovations.
The CU Cancer Center takes a multidisciplinary approach to cancer care and is home to numerous multidisciplinary cancer clinics that offer patients an “all in one” clinical care experience. Each multidisciplinary clinic (MDC)
focuses on a specific type of cancer. At an MDC, patients (including those seeking second opinions) are evaluated in one day by all of the specialists who take care of that specific cancer. This may include medical oncologists, surgical oncologists,
radiation oncologists, pathologists, genetic counselors, and more. After a patient is evaluated, the entire team of specialists comes together to discuss the best treatment plan for the patient and collaborate on care moving forward. This multidisciplinary
approach has proven to be the new standard of care for cancer care.
Due to advanced surgical techniques, more effective medicines, and a multidisciplinary approach to treatment, the CU Cancer Center is often able to treat patients who have previously been told they are not candidates for medical or surgical intervention.
For instance, we operate on 30% or more of pancreatic cancer patients, which is nearly double the national average.
There are also numerous cancer clinical trials being offered by CU Cancer Center members at any time. These trials often offer
patients options in addition to traditional cancer treatment and can result in remission or increased life spans.
Whenever you find a treatment, go ahead, but if you don’t find a treatment for your cancer, before you give up, ask and see if there is a doctor somewhere with options. Maybe it’s not a big city — maybe it’s in the middle of the Rocky Mountains that someone can take care of you when other doctors have told you that there is not a possible treatment.
Marco Del Chiaro, MD, CU Cancer Center member
There are numerous reasons to consider getting a second opinion for a cancer diagnosis or treatment plan.
For instance, a patient may feel that their doctor is underestimating the severity of their cancer or that they aren’t listening to or understanding their concerns. Other times, a doctor will refer a patient for a second opinion if they are not an expert in a particular type of cancer (especially rare cancers) or if their hospital doesn’t offer certain tests or treatments. Some insurance companies require patients to get a second opinion before they will approve treatment. Or a patient may simply want the peace of mind that comes from having their diagnosis confirmed and knowing they’ve explored all their treatment options.
A second opinion can also be invaluable for patients who suspect that they may have cancer even though their current doctor has ruled it out or declined to test them for it.
Patients who decide to seek a second opinion should do after they’ve talked to their current doctor about their diagnosis, prognosis, and available treatment options. It’s important for patients to have a complete view of what their first doctor recommends so that the doctor offering the second opinion can give a comprehensive assessment. However, since diagnosing and treating cancer as early as possible can have a significant impact on a patient’s prognosis, patients should start looking for a doctor who can provide a second opinion as quickly as possible.
One of the fastest ways for patients to find a doctor for a second opinion is to ask their current doctor for a referral. Although many patients fear offending their current doctor or hurting their feelings, it’s common for patients to seek second opinions, especially for cancer diagnoses, and most doctors are happy to connect their patients to doctors who can offer them.
If a doctor is unwilling to refer a patient for a second opinion or if a patient prefers not to ask for one, there are a variety of resources available to help find doctors who can offer them.
If a patient has health insurance, their insurance company may have a list of doctors they can choose from. Organizations like the American Medical Association, the American Society of Clinical Oncology (ASCO), and the American College of Surgeons offer resources to help patients find experts both in their area and across the country. Patients may also reach out to local hospitals, medical clinics, or cancer centers for local providers. Community websites like Nextdoor.com can help patients source recommendations for specialists from neighbors in their area.
When meeting with a doctor for a second opinion, the patient will want to provide them with as much information as possible, including their first doctor’s diagnosis and treatment recommendations, as well as any medical records, test results, and imaging scans. These can include pathology reports from biopsies, operative reports from surgeries, hospital discharge summaries, x-rays, CT scans, MRI scans, and a list of any past drug treatments and current prescriptions.
Because a cancer diagnosis can be overwhelming and often involves a lot of new medical information and terminology, many patients find it helpful to take notes when meeting with both their first doctor and the doctor offering a second opinion. Some may also choose to bring a trusted friend or family member with them as a “second pair of ears,” or even record their conversation (with each doctor’s permission). Patients should never hesitate to ask their doctors to repeat information or reword it in a way they can better understand.
After getting a second opinion, the patient will need to make a number of decisions. The patient will likely want to meet with both doctors to determine their next steps. They may want to ask both doctors to explain how they arrived at their diagnosis and treatment plan or ask if it is possible for the two doctors to review the case together. If the two doctors’ opinions conflict, the patient may decide to seek a third opinion from another specialist to help determine their course of action.
Regardless of whether the second opinion confirms or differs from the first doctor’s opinion, getting a second opinion can help patients feel more sure about their diagnosis and treatment plan.