TIPS TO LIVE BY

When Should You Get a Second Opinion for Cancer?

Sep. 1, 2021 - Katie McCallum

A cancer diagnosis not only brings a wide range of emotions, but it can bring a strong sense of urgency. You may wish you could begin treatment immediately — yesterday, even, if that were possible.

But rarely, if ever, does a cancer treatment plan start right away. And in the time between a diagnosis and beginning treatment, you may want to consider getting a second opinion about your condition.

"It's important to take time to understand your cancer diagnosis and prognosis, as well as evaluate the treatment options before moving forward with your care," says Dr. Patrick E. Prath, oncologist-hematologist at Houston Methodist. "Learning about your cancer, getting a second opinion and considering your options are rational steps to take that empower you to be more involved in your treatment."

But is seeking a second opinion always necessary?

5 times to consider getting a second opinion about a cancer diagnosis

"If you're diagnosed with a common cancer that's in its early stages and you're comfortable with the test results, prognosis and treatment plan your oncologist provides you, a second opinion may not be as important as it would be if you feel unsure about your prognosis or plan, your cancer is complex, or you're offered limited treatment options," says Dr. Prath.

Specifically, here are five situations in which Dr. Prath recommends considering getting a second opinion about a diagnosis:

1. You want to confirm your diagnosis or explore your treatment options

With a diagnosis like cancer, it's completely understandable to want to be sure that the plan set in place is the best one for you. This may be especially important if you are diagnosed with an aggressive cancer.

"Your diagnosis doesn't just help inform prognosis, it determines which treatment options are available to you," says Dr. Prath. "Even small changes in a cancer diagnosis can alter a treatment plan."

Unfortunately, diagnostic errors happen, and different oncologists can reach different diagnoses.

"A different specialist may have access to more precise imaging tools and diagnostic tests that reveal more details about your cancer — perhaps it's less aggressive than initially diagnosed, or maybe it's more aggressive," explains Dr. Prath.

Additionally, not all hospitals and doctors treat cancers the exact same way.

"A different hospital may have more advanced technology, more experienced oncologists or access to newer therapies through clinical trials. Different hospitals also operate differently. Some take a much more team-based approach to diagnosing and treating cancer," says Dr. Prath. "All of these factors can impact which treatment options are presented to you."

And even if your second opinion confirms your original diagnosis and treatment plan, the affirmation will boost your confidence and peace of mind.

2. You're diagnosed with a rare cancer or unusual subtype of cancer

Rare cancers are ones that affect fewer than 40,000 people per year. There are many types, but your oncologist can help you understand whether your specific type of cancer is rare or unusual.

"Since rare and unusual cancers occur less frequently, doctors see them less frequently. They're also more difficult to study and often have few treatment options. This means you may benefit from consulting with an oncologist who specializes in your type of rare cancer and who also practices at a cancer center offering cutting-edge treatments that might not be offered elsewhere," explains Dr. Prath.

3. Your treatment involves an invasive or life-changing surgery

Surgery is sometimes needed to remove a tumor. And if the surgical procedure presented to you isn't considered minimally invasive, consider getting a second opinion.

"There are new technologies and surgical approaches, such as robotic systems and laparoscopic techniques, that make many cancer procedures less invasive. These procedures are becoming more commonly available, but some still rely on a level of technology and/or surgeon expertise beyond what's generally found at most hospitals," explains Dr. Prath. "Not every cancer surgery can be minimally invasive, but getting a second opinion can help confirm that you're getting the least invasive approach possible."

Additionally, Dr. Prath recommends getting a second opinion if the surgery affects your physique or fertility, such as a mastectomy or gynecologic cancer surgery.

"In some cases, a robotic procedure can be used to remove cancer while sparing fertility. And many alternatives to the traditional mastectomy exist, including nipple-sparing mastectomy with immediate breast reconstruction," explains Dr. Prath.

4. Your treatment plan includes extended treatment

If your care plan involves taking medications indefinitely, a second opinion can ensure you're taking appropriate action.

"There may be a new, more effective treatment available that's not offered just anywhere or a clinical trial taking an innovative approach to treating your type of cancer," says Dr. Prath.

A second opinion is also a way to make sure that you're choosing a care team that offers all of the services needed to help you effectively manage your extended treatment plan.

"This is about more than just regularly seeing your oncologist about your condition and side effects you might be experiencing," adds Dr. Prath. "It's about finding a team that offers care beyond your physical needs from the get-go."

The services that can help you effectively manage and cope with extended treatment for cancer include:

  • Nurse navigators
  • Counselors
  • Support groups
  • Diet and wellness programs
  • Caregiver resources
  • Chaplains
  • Social workers
  • Financial assistance

5. Your cancer isn't responding to your established treatment plan

"Cancer is a complex disease and, in some cases, the initial treatment plan doesn't show the results one hopes to see," says Dr. Prath. "If this is the case, a second opinion can help determine whether there might be a different way to approach your cancer."

If no other options are available, it can also provide peace of mind that you've exhausted all treatment avenues and left no stone unturned.

What to do with your second opinion

If your second opinion agrees with your first, you can simply take that peace of mind and move forward with your treatment plan.

But, what about if the two don't match up?

"Things get tricky when the two opinions disagree. Who's right? It's hard for a patient to rectify inconsistencies in diagnoses or treatment options," says Dr. Prath. "But, if it happens, it's critical for you to work closely with each doctor to understand how he or she came to his or her respective decisions."

Consider asking these questions:

  • Which tests did you use to form your diagnosis?
  • What was your interpretation of the results?
  • Which guidelines or studies did you reference?
  • Did you consult with a team of other specialists, such as at a team tumor board review?
  • Do you have experience diagnosing and treating a case similar to mine?
  • What are your thoughts on the alternative option I've received?

And consider these tips:

  • Take detailed notes or ask if you can record the conversation
  • Bring a family member or friend with you to help reduce the chance of information being misinterpreted
  • Ask both doctors if they're willing to review your case with each another


Next Steps:

  • Our nationally recognized oncologists work as a multidisciplinary team to offer second opinions and use the latest research, treatments and technology to stop cancer. Learn more >
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Categories: Tips to Live By
Tags: Cancer