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Gynecology and Obstetrics

Most physicians welcome the opportunity to have a consultant review and approve their care decisions—or perhaps suggest another treatment that may be a better option. There are instances in which a patient may disagree with the primary physician and will need to seek care elsewhere, but this is not the main purpose of a second opinion. Most of the time, you simply need to make sure you are getting the best advice. Many insurance and healthcare companies, however, do pay for second opinions and acknowledge their importance.

If possible, the best place to get a second opinion is from a physician at a cancer center that has expertise in your cancer type. Although the specific situations in which a second opinion is most useful have not been defined, there are clearly situations where a second opinion would be helpful and most patients would benefit. These may include:. Poorly understood diagnosis: Patients who feel that they may not fully understand the diagnosis and their treatment options should consider a second opinion. Another physician may communicate in a way that the patient can better understand, or simply hearing the diagnosis a second time may help the patient overcome any denial they may have.

Initial diagnosis by a non-cancer specialist: Patients who have been diagnosed by a non-cancer specialist benefit from a second opinion. In the United States, doctors other than oncologists often diagnose and treat patients with cancer. Cancers are diagnosed and treated by family doctors, internists, pediatricians, gynecologists, urologists, ear-nose-and-throat doctors and other non-cancer specialists. In most instances, appropriate therapy is administered. However, patients not treated by specialists in cancer treatment should consider seeking a second opinion.

Getting a Second Opinion - Womens Care OBGYN

In some situations, physicians will not refer patients for a second opinion because they may lose control and revenue from treatment, they may be threatened by having their patient believe some other doctor is more knowledgeable, or often they are just too busy to consult other physicians. The patients of these types of physicians are probably the most in need of a second opinion. Diagnosis by a cancer sub-specialist: Many types of cancers are treated by several different types of cancer specialists.

Each specialist may think that their treatment is the best treatment for the patient. An example of this is in the localized prostate cancer, where:. For this reason, a patient with cancers that are treated by sub-specialists may want to consult an oncologist general cancer doctor or multidisciplinary team to obtain a thorough understanding of treatment options.

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Seeking a second opinion from a different type of specialist can be informative but it can also, unavoidably, create confusion about treatment options. The best way to resolve this confusion is to gather and use all of the available information to making an informed decision. Apparent lack of treatment options: A second opinion can be useful in some patients who are told that there is no appropriate treatment for their cancer and that there is no hope of survival or relief of symptoms from the cancer.

When you really need a second opinion

Such patients have nothing to lose by seeking a second opinion. In this situation, patients should seek out physicians and institutions that specialize in treating their type of cancer and perform clinical trials. Often, this is accomplished by finding out who is performing clinical trials of novel treatments for the type of cancer in question. Here again, information available on the Internet can help locate such physicians and institutions. A treatment plan that involves a clinical trial: When participation in a clinical trial is recommended by the treating physician, a second opinion should probably be obtained to make sure this is the appropriate treatment.

There are many types of clinical trials, some of which may benefit a patient with a specific cancer and some of which may not.

When should I seek a second opinion regarding treatment?

Doctors participate in cancer research by enrolling their patients in clinical trials; however, they often have trouble finding patients to participate. Unconsciously, such doctors may suggest a trial that may not represent the best treatment for a particular patient. Rare cancers: When dealing with a rare cancer, it is usually best to seek a second opinion, unless the diagnosis is made at a center that specializes in the treatment of this cancer. If a local expert is available, treatment should probably be switched to that doctor.

If the expert is far away, which is likely, the home physician can usually coordinate treatment by phone or e-mail. Usually patients with kidney cancer are treated on clinical trials carried out in one of several large institutions. This is because the clinical trial may require specialized treatment and there are not enough patients with kidney cancer at one institution to make the research meaningful. Surgery as primary treatment: If there is any doubt about the operability or inoperability of a cancer, a second opinion is in order.

In this situation, patients are urged to seek second opinions in institutions where large numbers of patients are treated. For instance, esophageal cancer may be considered inoperable in a hospital that performs one such procedure a month, but may be considered operable in an institution that performs several per day. Just as important can be the determination that a cancer deemed operable is in fact inoperable and surgery would be harmful.

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Small hospitals and rural practices: Patients who live in a rural area and get treatment at a small hospital probably should get a second opinion from a larger medical center before treatment is initiated. Although smaller hospitals typically deliver excellent treatment, it is prudent to ensure that the recommended treatment is appropriate and can be safely administered.

Small and rural hospitals may not see a large volume of cancer patients, and while they are usually fully capable of delivering treatment, it is best to seek a second opinion to help determine what the appropriate treatment is. Sometimes, the recommended treatment will determine whether a patient should receive their treatment locally or travel to a larger medical center. For example, most small hospitals can effectively deliver chemotherapy; whereas patients requiring a complicated procedure, such as a stem cell transplant, may need to travel to a larger institution that treats a higher volume of patients.

Specialized treatment: Not all medical centers offer the specialized treatments that may offer the best results for some patients. In these cases, a second opinion may be in order. For example, bone marrow or blood stem cell transplants may offer the best chance for cure or control of the cancer for patients with blood and lymphoid cancers such as leukemia, lymphoma, and multiple myeloma and other cancers such as breast, ovarian, and testicular. Specialized treatment may also be required for cancer involving the liver, a common site for metastases.

Once the cost estimate is given, we require the patient to fill out the Credit Card Authorization Form. We will not charge the credit card until we confirm with our medical team that the health information that has been submitted is sufficient to provide the patient with a second medical opinion.


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