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Second opinions and liver mets

saussureainvolucrata's picture
Posts: 54
Joined: May 2013

I hear on this forum again and again about how important it is to get a second (third, even fourth) opinion, if the first surgeon's opinion was a "no" to resection of liver mets. You've got me convinced. I am now researching about good liver surgeons who are known to have taken up "unresectable" cases. I need your help, dears:

1. How expensive is it to get a second opinion? We might have to pay out of pocket. Our oncologist says getting a second opinion is expensive, and can cost 10,000. Does that sound reasonable?

2. In order to get an opinion from a different liver surgeon, do you just contact the other doctor and send him/her the necessary scan/test results? Or does your oncologist refer you to another doctor?

3. Do you know any website that has information about the quality of liver surgeons? Do you know good doctors yourselves?

Any advice, information will be greatly appreciated!

Lovekitties's picture
Posts: 3357
Joined: Jan 2010

Hi, if you tell us where you live...largest near city...perhaps someone on the board will have direct input for you.

Do you have insurance?

The cost of 10,000 does not seem reasonable...if that is US Dollars.

What I beleive normally happens is you request an appointment with the doctor you select telling them that you want a second opinion.  They will tell you what labs, scan, etc. they would need in order to make an assessment.  Some like to have these things prior to the visit.  If this material is fairly current there should not be a need to re-do them.

Getting a referal from one of your existing doctors is not a good idea, because their association could sway the second opinion to the same as the first. 

If you give us more info, others may be able to offer more help.

Marie who loves kitties

saussureainvolucrata's picture
Posts: 54
Joined: May 2013

Thanks Marie. We're in Illinois, Urbana-Champaign. My mom is getting treated at Carle Cancer Center. She's not insured. Her oncologist indeed seems to think that getting a second opinion will cost in the range of 10,000 dollars.

lp1964's picture
Posts: 1240
Joined: Jun 2013

A second opinion is only a consultation and it should not cost more than a few hundred dollars. You can call ahead and ask. $10,000 sounds like it would include the treatment. Does your mom have Medicare or have you thought about insuring her now under the new health care law? Now they have to cover her even with pre-existing condition. It maybe expensive, but surgery is extremely expensive .

I hope you will find something and I wish you best of luck.


Lovekitties's picture
Posts: 3357
Joined: Jan 2010

Does your mom qualify for medicare, medicaid or any type of medical financial assistance?

If the answers to the above are no, then that is a tough spot.

If all else fails, I would say go ahead with the recommended plan, sign mom up for insurance under Affordable Care Act which would be effective January 1, 2014.  Those with existing conditions cannot be denied insurance begining Jan. 1.

Go to https://www.healthcare.gov/ to see what coverages and prices are for her to be covered.

The $10,000 for JUST as second opinion still astounds me.  You can always check with a doctor about a second opinion and ask about the cost before commiting to an appointment.

LivinginNH's picture
Posts: 1458
Joined: Apr 2010


That's absurd - $10k for a consult!?? It shouldn't cost any more than the first appointment with this current doctor.  This is what I did - simple.  I called Mass General, set up an appointment with Dr. K. Tanabe (liver surgeon), and brought him the current scans.  Done.  But as the others have mentioned, the subsequent surgery without insurance would probably be an issue.  Obamacare started today for sign up - as long as the servers are working again....   ;)

Good luck with everything,


herdizziness's picture
Posts: 3642
Joined: Apr 2010

Boy that  sure is trying NOT to Have you all get a second opinion, what a arse. The cost for a second opinion should be around $200.00 to a little over $300.00, my liver surgeon charged $325.00 for a consult, he was thorough and great.  That's California is prices at an expensive hospital, so this should be Less expensive.

What you do is talk to people in your area, find one that specializes in oncology liver surgery, check him out on the web (ratings from other patients) then tell your oncologist this is who you want to be referred to. Make sure to take a copy of your last CT and/or PET scan with you for them to download, the Dr. will look that over before coming in to talk to you.

I highly recommend a second opinion Or two even.

Winter Marie

Posts: 509
Joined: Sep 2012

I agree with all of the above. $200.00 - $350.00 is all a second opinion does cost.  I feel like that price has got to include treatment/surgery. 

Also, the new health care plan does seem to be the way to go if your mom is not eligible for other programs.  I have had referrals from my doctors as well as calling on my own to hospitals.  Some will not see you unless your doctor calls.

I had one hopital refuse to see me because after they looked over my file they said my disease was too wide spread.  My doctor called and I was in within a week.  So really it depends.  If you need to push around and step on a few toes .. then that is what has to happen .. it is too important not to. (and the treatment plan they gave was not the same as my referring facility either)

One thing they did all want before was my file sent to them and my imaging on cd's.  This is very important because we have large files that need time to review, and a good facility will bring it to tumor board for review.

Best of luck to you in your journey. 

tanstaafl's picture
Posts: 1299
Joined: Oct 2010

In the US, for a single consultation, hundreds dollars that should be largely covered by insurance.  Some have spoken of advanced cancer centers that do over much of the diagnostic workup and charge thousands, sometimes covered by insurance.    

Resectability can be improved by neoaduvant (presurgical) treatment, like ordinary chemo or by HAI, Hepatic Arterial Infusion.  The individual surgeon or site can make a huge difference. Renw is talking about getting accepted with less than 10% useful liver for ALPPS.

Don't just let someone write you off.  In complicated cases, you have scratch and dig to find, and convince, the right surgeon.  In the mean time you  are improving yourself as a patient,  getting more useful information, improving your interview skills.   2½ years ago, we went through several surgeons, by self referral, all saying "no" (para aortic lymph nodes), to get a first "yes" that would do the job, and then got an even better "yes" from a competitor hospital.  My wife is in great shape today.

Also we have repeatedly seen that people needed things like high dose vitamin D3, cimetidine, PSK, with or without chemo to improve their odds, and the doctors are generally very weak on this. 


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