It is always a good idea to get a second opinion when diagnosed with cancer. Because only 48,250 individuals will be diagnosed with oral cancers, and another 12,500 with laryngeal cancers for which the risk factors are sometimes the same, general oncologists may not see the number of oral or head and neck cancer patients that a specialist sees, and may not have the most current information on treatment options. Also, there is a possibility that you may have been misdiagnosed. Since the final diagnosis determines the specific treatment a patient will receive, a second opinion by a specialist is a good idea for patients facing major cancer treatment. OCF also believes that after diagnosis, the best treatment plans come from a multidisciplinary team at a tumor board meeting. This is normal protocol at any major cancer center, but may not be done if you are only seeing a single doctor of a particular training, like an ENT/otolaryngologist who is trained in head and neck surgery. A group of doctors discussing your case who all come from different training, such as radiation, surgery, and chemotherapy will provide the best treatment plan idea for you given your particular staging.

Many patients worry about telling their doctor they plan on seeking a second opinion, but they should not. Most doctors are comfortable with the request, as it is common for patients to seek a second opinion. Ask that your medical records, original x-rays, and tests results be shared with the referral doctor.

Does Everyone Need a Second Opinion?

By Ernest H. Rosenbaum, MD

When a person comes in for their initial consultation after a cancer diagnosis, they bring a multitude of problems. Usually they come for a comprehensive diagnostic work up after they have already been given a diagnosis of cancer. They arrive at an oncology office in a state of alarm and fear. They also have grave questions about their future life. The first problem I find is the way in which they were given the diagnosis. Usually, it is through a follow-up call after a biopsy and/or test to tell them that they have cancer. Receiving the diagnosis produces a strong emotional reaction. Most people are shocked and devastated, needing more time to fully comprehend the meaning of cancer.

Most general medical cases are usually straightforward. A diagnosis is made and treatments are initiated. Thus, many patients may not need a second opinion. But when a diagnosis of cancer is made, there is much fear, misunderstanding, and many questions about therapy. All these factors can determine whether a person may live or die, thus it is not unreasonable to a patient to want to have another point of view-what we call a second opinion.

After analyzing the cancer data, the most important thing a physician can give to a concerned patient or family is to explain, in simple terms, all the pertinent issues. Patients wish for state of the art medical care, but they may have doubts about what is the best way to proceed. Although this is when a second opinion can be very helpful, most patients are reluctant to offend their primary physician by doing so. Many patients do not realize that getting a second opinion is standard practice.

Unless emergency treatment is needed, I feel it is very important for the patient and their family/friends to allow themselves time to learn exactly what the diagnosis means. They need to gather information on how it can be treated (surgery, radiation, or chemotherapy), weigh the options (if immediate treatment will have a consequence in their particular disease), and understand the prognosis and the chances for a cure.

Most patients are now well informed often having gathered information from the Web, (Internet or PDQ Physician Data Query/CancerNet), newspapers, magazines, or from their well-meaning friends. This information is often very mixed and confusing.

It often takes time and several explanations going over the same questions for an anxious and fearful patient to understand and be satisfied with the medical recommendations. Often there are several approaches to a problem and sometimes there is no definitive answer, given the limitations of current medical science.

To help patients make proper decisions; I make a point of informing them and their family/friends at the initial visit that I have two rules in my practice (included on the tape recording that I do for all my consultations). If they are coming for a second opinion, I clarify that they will continue their care with their primary oncologist.

Rule 1. If I am uncertain or have any questions on the diagnosis or treatment, I will advise them that I would like them to get a second opinion. I state that I would be glad to recommend the person and place which I think would offer the most beneficial consultation to add additional information on how to proceed with their oncology evaluation or therapy.

Rule 2. If at any time they wish to seek a second opinion, as is their right, I would be glad to provide my records, test results, x-rays and pathology report to whomever they wish. If they would like me to select and help arrange a second opinion consultant, I would be available to do so.

I can recall a case where mine was the 9th opinion. This reflects how it may take multiple discussions with your doctor or with another independent unbiased physician to arrive at a conclusion that can give you peace of mind and satisfaction about which is the appropriate therapy.

Source: Cancer Supportive Care


Second Opinion: A Valuable Part of Supportive Care

By Malin Dollinger, MD, FACP

None of us are prepared to be told that we have cancer. It’s like a membership in a new club, one we didn’t know existed, didn’t apply for, and don’t want to belong to. Everyone seems to treat us differently. All of our old priorities and life suddenly change. We need to know RIGHT NOW what is going on, how bad the cancer is, where it is, where it has spread. What are the choices for treatment? How successful is each one? What are the risks and side effects of each treatment? Is one better than another? Why? What should I do? How much time do I have to decide? For that matter, how much time do I have?

Thank God you have never had to ask and answer these questions before. Somewhere in the back of your mind, you were worried about an auto accident or breaking a bone, or needing an operation, but you have absolutely no training or experience in having cancer. How do you make d