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lp1964's picture
Posts: 1159
Joined: Jun 2013

When I was diagnosed I got plenty of "second" opinions, but I believe these were not incompletely independent second opinions. I had my oncologist and my radiation oncologist of the same institution, which is good as long as it is just routine chemo. As soon as you have options of different chemo drugs or type of surgeries, it's better to get an independent opinion. The mistake I made that at the beginning of the consultation I let each new surgen know what the previous surgens said, so there was a chance that their opinion was biased and not completely independent.

Real independent opinionmeans not a different doctor from the same institution and don't let each new doctor know what the previous dontor said about your situation. Only the cold facts, scans, lab results.

What do you think?



mp327's picture
Posts: 3735
Joined: Jan 2010

Your advice is right on.  Mentioning to a second doctor another doctor's name who has already rendered an opinion on your case is just setting yourself up for the same advice, whether it's good or bad advice.  Doctors, even though they might not be in the same practice or the same town and may not even be familiar with each other, are hesitant to go against each other.  I feel that's not in the patient's best interest, but it happens all the time.   

Posts: 1122
Joined: Aug 2012

I agree, Laz. A real second opinion has to be at a separate cancer hospital. A cancer patient has to do a great deal of research to find out where to get the best treatment available. Not all hospitals and doctors are equal. The first thing a patient has to do is to find out what the protocol is for the particular cancer. You can start by finding the NCCN guidelines. Some cancers have commonly accepted protocols for treatment. Some do not .

The next thing a patient has to do is to research cancer hospitals to find out which hospitals have the best reputation for the particular cancer. You can find ratings of hospitals treating cancer at US News and
World Reports. They rate cancer hospitals on many levels, including survival rates. As an example, there are very few doctors who are experts in neuroendocrine cancer. There is no known cure at this point, so there is no protocol, other than surgery. I first had to find experts and then compare hospitals. Experts in this field are not shy about telling a patient what their real opinion is and will readily contradict a doctor without the same level of expertise.

When I was working in a firm that did medical malpractice, I was shocked to see that the medical community is reluctant, generally, to testify about
accepted community standards in medicine. Doctors do not like to contradict each other. I was also shocked that most patients had not researched doctors or hospitals. One patient had gone to a doctor who had many malpractice suits pending for the same surgery that she had with him. The information was readily available. She had never checked the state's board of medicine information portal .

A real second opinion should occur from an independent expert in the cancer that the patient has at a hospital who is very highly rated.

Posts: 1139
Joined: Oct 2011

You are so right. When I got a second opinion on questions I had regarding colostomy reversal, radiation dammage, possible reconstruction, and benefits and risks of a hysterectomy after the treatments I've had, I went to a larger hospital, completely different institution several hours from home. I researched various doctors in that area and set it all up on my own leaving my current medical team mostly out of any conversation. I was actually happy and felt reassured that the specialists were in agreement with the doctors I currently see. I did have more peace of mind after seeing someone else though, and am happy to not have been made more confused if the opinions didn't match.

Hope you are getting the rest you need to heal.

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