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Second Opinion

TomM1956728
Posts: 64
Joined: Apr 2011

Hello,

I wanted to ask for your kind help.

My 87-year old mother has been receiving treatment for esophageal cancer for over a year and a half.

She is receiving treatment at a large and well known clinic/hospital which has a number of oncologists.

Despite the good reputation the clinic/hospital has, we were not happy with her oncologist. In fact, we were unhappy with him from day one.

Nevertheless, my mother continued to receive treatment from the same oncologist because my understanding is that this person specializes in treating esophageal cancer.

The other oncologists seem to be more involved with other types of cancer (stomach cancer, breast cancer, prostate cancer, etc.).

Since we believe that the oncologist is not giving my mother proper attention, we would like to get a second opinion.

I was thinking of asking the current clinic/hospital for a referral to another oncologist in the same medical facility. I think that most oncologists would probably be able to treat esophageal cancer.

However, I’m concerned that since the oncologists are all working at the same clinic/hospital, they would probably confirm what her present oncologist is doing and would not want to alter her treatment.

Also, I imagine there is some camaraderie among the staff and, therefore, the new oncologist may not like the fact that we changed our doctor and that would affect the treatment my mother receives.

I was therefore thinking of getting a second opinion at a different clinic/hospital. There is another facility that is about an hour and a half’s drive from where we live and it also has a very good reputation.

My concern, though, is that after reviewing her records, the new clinic/hospital may not want to treat her since she is a stage four patient. Or they may not want to treat her for some other reason. (She only has Medicare so I think that may limit the treatment she receives).

If we then try to return to the current clinic/hospital, they may not accept my mother back. Or, if they do, they will give her even less attention than they are presently doing since she tried to switch to another medical facility.

I’ve never really dealt with a serious medical issue that may require a second opinion so I’m not sure how it could be properly handled so that it doesn’t create many difficulties.

I would greatly appreciate hearing any advice and information in this regard.

Thank you once again for all your kind assistance.

Tom

Ladylacy
Posts: 515
Joined: Apr 2012

If you aren't happy with your mother's present oncologist, by all means get a second opinion and if he is a good doctor, he won't mind. Actually you do need an oncologist who specializes in EC cancer, that is the best one to have. We found this out when my husband was diagnosed with laryngeal cancer and had the oncologist who was treating him for a rare blood cancer, treat his laryngeal cancer. To make a long story short, my husband ended up having to have a complete laryngectomy and he was referred to Emory Winship Cancer Center and a surgeon who specializes in this type of cancer. Then a year later they found out that he had a tumor (cancer) at the cervical of his esophagus (2nd primary). This is a rare spot for cancer. After meeting with the oncologist, radiation oncologist at Emory and then with the oncologist who did the first treatment and even the first radiation center, we decided to go with the doctors at Emory. First oncologist, we like very much, but he is young and inexperienced. In fact he felt that my husband didn't need the chemo, just the radiation, while all 3 doctors at Emory felt he needed the chemo and radiation. So get your second opinion, but one from a specialist in EC cancer. My husband went thru a 35 radiation (2nd round of radiation) and 7 chemo treatments and we are now waiting until mid-September for a PET/CT scan to see where he stands. We have been told that due to his previous radiation and surgery and the location of this tumor that surgery would be, in all likelihood, with major complications.

Also don't feel that since your mother is on Medicare that this will hinder anything. My husband in on Medicare and we have had no trouble whatsoever. Just make sure the doctor or cancer center takes Medicare.

Wishing the best for your mother and you. Sharon

TomM1956728
Posts: 64
Joined: Apr 2011

Thank you Sharon for your kind response.

I’m very sorry to hear about the problems your husband went through.

Based on what you mentioned about your husband’s experience, I will make sure my mother gets a second opinion from an oncologist who specializes in EC.

I’m glad to hear you haven’t had any problems with Medicare. So far, my mother hasn’t had any problems either but since her doctor offers her no other options except chemo, I was wondering whether perhaps he is not offering her any other treatment cause her insurance does not cover it. Good to know that’s not the case.

Thank you once again for your kind response. I sincerely hope your husband gets better and I wish you and your husband all the best. God bless.

Tom

Ginny_B's picture
Ginny_B
Posts: 537
Joined: Sep 2011

My mom was 84 when she was diagnosed. We had excellent care by physicians we really liked. Once when mom was in the ER all tests came back showing she was ok, fine, nothing going on, but I insisted she was not breathing right. After 12 hours in ER (they had 2 heart attack victims come it and it delayed mom's stuff), the Oncologist refused to give up and at 11 pm ordered a D-Dimer test. It came back positive. Mom had CT scan and they found fluids in lungs and heart. She was in the hospital for a week following that ER visit.

Anyway, even though I liked her Onc very much as well as her radiologist, we went for a second opinion. All the docs agreed to follow his protocol and none of the docs felt slighted or angry, etc. They all worked together on behalf of my mom.

In short, don't hesitate to get a second opinion. Be a squeaky wheel. Ask and ask and ask. Demand and demand. In the ER every time they'd say this test was fine, that test was fine, I'd say BUT BUT BUT!

Keep up the good fight. Post often!

TomM1956728
Posts: 64
Joined: Apr 2011

Thank you very much, Ginny. That was very helpful to know. And it has motivated me to seek a second opinion.

My mother is trying to get an appointment with her oncologist next week to let him know that she will be seeking a second opinion.

Thank you once again for your kind help.

Tom

unclaw2002's picture
unclaw2002
Posts: 664
Joined: Jan 2010

Tom,

It depends what type of Medicare your mother has. Is she on regular Medicare with supplemental insurance --- or is she signed up for a Medicare Advantage Plan (aka an HMO)? If she is on regular medicare she can self refer herself for a second opinion without a problem. If she is on one of the Advantage Plans then she needs to get an approval for a second opinion and that can be nearly impossible. There is a yearly enrollment period that allows you to change plans.

When my dad was first diagnosed at 78 with Stage III EC he was on a Medicare Advantage Plan through Humana. He lived in New Orleans and there were no recognized NIH Cancer Centers in New Orleans. His doctor tried to refer him to Sloan in NY City for a second opinion and HUmana denied the request and said he could get a second opinion from another local doctor. My father's physician fought the appeal to no avail. My dad paid out of pocket for that second opinion, it totally changed his treatment and he got 2 more years from a dismal prospect. Luckily the enrollment period for Medicare plans was happening at the same time and we switched him from the Advantage Plan to regular Medicare (his supplement was Tricare for Life) and never again had problems with seeking advice, treatment or care.

Best,
Cindy

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