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The value of a second opinion

Author: Mia James

Choosing a treatment plan for a cancer diagnosis is a big decision. There is often more than one approach available for each type and stage of cancer, and you want to choose the one that not only gives you the best chance of a good outcome but also fits your quality-of-life goals. You may find that an expert second opinion helps you make the most informed choice.

A second opinion, explains Brion Randolph, MD, a Medical Oncologist/Hematologist at Cancer Treatment Centers of America® (CTCA) in Newnan, Georgia, “is when a person visits another physician to obtain a different point of view on the options for treating a disease.” He says that the process helps ensure that you are fully informed of your treatment possibilities.

Seeking a second opinion

Though you can seek a second opinion at any stage in your decision-making process, there are times when it may be most helpful. Specifically, Dr. Randolph suggests consulting an additional doctor before you begin treatment. You may also want to seek a second opinion if your original doctor has proposed a change to your treatment plan.

Just as choosing your original doctor or hospital is an important decision, so is finding an expert for a second opinion. If your diagnosis is rare or complex, you may need to see different types of doctors—such as a medical oncologist, surgeon and radiation oncologist—who all work together on your treatment plan. In this case, Dr. Randolph says, “You might consider a facility that can provide all the expertise under one roof.” He also suggests that patients “look for doctors with experience in treating the specific diagnosis in question and those who have access to the latest technology.”

Dr. Randolph says that insight from other patients who have been treated at a certain hospital or by a particular doctor can help you choose where to get a second opinion. When you contact a hospital, ask if they can put you in touch with other patients who are willing to share their experiences.

Once you have selected a hospital and a doctor, to get the most out of your appointment Dr. Randolph advises that you “take notes during the visit and try to prepare questions in advance.” A friend or family member can accompany you to help you take notes and to observe the visit. It is ideal if you can have someone in this role at your original appointment as well, to ensure that you have all the information from both visits. “It is best to have the same person at each of the visits,” Dr. Randolph says; this way your support person can record and remember the discussions and help you compare information from both doctors.

Using the information

Once you have received a second opinion, it is time to put the information to work. Dr. Randolph suggests that you first make sure you understand the input from both doctors—original and second. Reviewing the notes from both visits and following up with both doctors about any questions you have can help ensure that you have a good understanding of both opinions.

It is possible that the first and second opinions may closely match, but be prepared for them to differ and even conflict. To avoid becoming confused by two separate conclusions or recommendations, ask both doctors why their opinions do not match. “If there is a conflict between the information provided by the two different doctors, try to address this conflict during the visit to be sure you understand why there is a difference,” Dr. Randolph recommends. There may be an explanation that helps you make the best decision for your individual circumstances.

When you have finished the second opinion process, it is time to choose a treatment plan. You and your care team will consider clinical factors, such as risks and benefits of the potential approaches, and you can also consider your personal needs and work and family responsibilities. For example: If one plan requires traveling to get treatment, are you able to be away from home? If you will continue to work during treatment, which approach best accommodates your schedule?

Your doctor is of course a key part of your treatment plan, and the second opinion process can help you choose a physician in whom you feel confident. In addition to understanding the treatment plan and how it fits your life and health goals, Dr. Randolph says, “The most important part of selecting a treatment plan is to be sure you are comfortable with the doctor.” The second-opinion process can be like an interview—it is your chance to meet different physicians and choose the one who works best with your needs.

Feel confident about getting a second opinion

Though in theory a second opinion sounds like a practical step in the decision-making process, in practice some patients are afraid that they would be betraying their original doctor by seeking input from another physician. This should not be a concern, says Dr. Randolph. He explains that, in fact, doctors who are dealing with complex diagnoses such as cancer often encourage patients to get advice from another doctor. “Physicians want their patients to do well,” he says. He explains that you improve your chances of a good outcome by becoming fully informed about the diagnosis and treatment options, including approaches that hadn’t been presented to you before: “Through seeking a second opinion, patients may discover new and innovative treatment options that were unavailable in their own community.”

Two opinions, one solid decision

Seeking a second opinion is like doing research on any major decision in life. It is not likely, for example, that you would buy a home or even a car without first looking into your options. But unlike many other big decisions, choosing a treatment plan has a real and direct impact on your well-being. So be an informed consumer when it comes to your health care: Research your options and make the choice in which you are most comfortable and confident.

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