Getting a Second Opinion

By Judy Germany

If you’ve been diagnosed with cancer, you may want to get a second opinion from another specialist before you begin treatment. A second opinion is an especially good idea if you feel uncertain about the proposed treatment or you think your doctor underestimates the seriousness of your illness.

Even if you like your doctor and trust his or her treatment plan, you should still consider getting another opinion — not only to confirm the cancer diagnosis but, more important, to make sure you learn about every available treatment. In fact, many patients who get second opinions end up staying with the doctor who diagnosed or initially treated them, but talking to another specialist can empower you to make decisions based on fully understanding all of your options.

The following tips will help guide you through this important process:

Getting Started

  • Begin by telling your doctor that you want to get a second opinion. Cancer patients commonly seek a second opinion and some health plans actually require one, especially when a doctor recommends surgery or an experimental therapy. But some people may not feel comfortable talking to their doctor about getting another opinion. To make discussing the issue easier, tell your doctor that you are satisfied with his or her treatment plan and care, but that you want to ensure you are thoroughly informed about all available cancer treatment options. It may help to bring a family member or friend along for support when you have the conversation.
  • Ask your doctor for copies of your medical records, original x-rays, lab and test results so you can take them with you on your first visit for a second opinion. You can also have the new doctor’s office request your records from your primary doctor if that is more convenient. It’s a good idea to request copies of your medical records even if you don’t plan to seek a second opinion, in case of an emergency. Your doctor’s office may charge a small fee to copy the records.

Where to Look?

  • The best person to recommend a doctor for your second opinion is your oncologist. If you don’t have an oncologist, ask your primary care doctor. He or she should be able to give you the name of at least one specialist who has experience treating people with your diagnosis, even if it means sending you to another hospital or facility.
  • If your doctor isn’t able to recommend another specialist or if you want more options, a good way to judge the quality of cancer care at a treatment facility is to find out if it has been approved by the Commission on Cancer, a program of the American College of Surgeons. If it has, you know that it offers a range of cancer care services and is committed to providing the best in state-of-the-art diagnosis and treatment. To find a Commission on Cancer-approved facility, look for the treatment center locator on the American Cancer Society Web site or call the American Cancer Society at (800) 227-2345.
  • Some hospitals and communities have physician referral services available by phone or online. These allow you to learn more details about the doctors in your area, such as their areas of expertise, medical certifications, office locations, languages spoken and so on. You can find these referral services through many hospitals, or ask your primary care doctor about them.

Finding the Right Doctor

  • Look for specialists who have experience treating your type of cancer, especially if you have one of the rarer cancers. Larger institutions, including academic medical centers such as Rush, will have more experience with rare or complex cancers than community hospitals. Studies have shown that the more experience doctors have treating a specific condition, the more successfully they are able to treat it. The best way to determine whether doctors have experience is to ask them how long they have been treating patients with your diagnosis, how many they have treated total and how many they treat in a given year. Your oncologist or primary care doctor may also be able to tell you which specialists are among the leading experts for your type of cancer.
  • If possible, based on insurance and how quickly you need treatment, schedule appointments to interview several doctors. This will enable you to choose a doctor for your second opinion based on which doctor is the best fit. Ask them whether they are board certified, how long they have been in practice, which treatments they offer, what their office hours are and other information that will help you make a decision. If you are meeting with surgeons, find out how often they perform the type of surgery you need, how many they have performed, what their success rate is and whether there are any alternatives such as minimally invasive procedures that may be right for you.
  • In addition to finding the right doctor for your second opinion, make sure you are comfortable with the nurses, technicians and support staff. They will be the ones providing your day-to-day care, answering questions and helping you schedule appointments, deal with your insurance company, obtain prescription refills and other important issues.
  • Look for hospitals or facilities that offer supportive services for cancer patients. For instance, Rush in partnership with the American Cancer Society offers a patient navigator who meets with patients and family members to assess individual needs and provide vital support, including information about available treatments, community services and programs. And through the Cancer Integrative Medicine Program at Rush, patients have access to therapies that complement their medical treatments, such as acupuncture, biofeedback, massage, yoga, and nutritional and herbal counseling. You may also want to know about the availability of cancer support groups for you and your family members.

Timing is Everything

  • If your cancer doesn’t have to be treated immediately, try to get a second opinion before you start your first treatment. Another doctor or hospital may have options such as new therapies available through clinical trials that are better for you. Your doctor can tell you how quickly your cancer needs to be addressed.
  • It shouldn’t take more than a week for a doctor’s office to obtain records from your doctor and schedule you for a second opinion appointment. It may take even less time if you plan to bring your medical records to the appointment rather than asking your primary doctor to forward them. If you have to wait more than a week or two to see a doctor for a second opinion, you may want to find someone else.

Insurance Issues

  • Before you schedule your second opinion appointment, contact your insurance company to find out what your policy covers. You may be required to get a second opinion from a doctor who is associated with your plan, and your insurance company may be able to provide you with a list of approved specialists.

If you don’t have health insurance, find out whether the hospital where you plan to get your second opinion has options to help offset the cost of cancer care. Many hospitals will help patients apply for Medicaid, offer payment plans or have charity care provisions. Some hospitals, including Rush, have staff available to help patients deal with insurance-related issues.

Rush Resources:

Judy Germany is a senior editor/writer for Rush University Medical Center.

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