Second Opinion Misconceptions for the Newly Diagnosed and Others

13 years 5 months ago #10477 by momof4
For the Newly Diagnosed and Others

I think that the idea of a second opinion scares some people. They are under the misconception that every test that the First Dr. did to come to the conclusion and their diagnosis, will have to be repeated when they go to the Second Dr.

****(Not that it never happens, sometimes if the Second Dr. feels that something was done wrong the first time they will retest.)*****

But, for the most part, you are going to just bring your Pathology Reports, test results, and all of your records. You will have a consultation with the Second Dr. in his office NOT IN THE EXAM ROOM. If he wants to exam anything, this will be done after your conversation with him, and only if he feels it is beneficial. You will just be sitting there discussing the previous results and asking what his thoughts are, his recommendations, and basically interviewing him to see if you feel he is a better choice than the first.

You are under NO obligation to get undressed, agree to an examination, or any other evasive test. These choices are yours.

1. Ask how many cases similar to yours he has seen

2. What is HIS protocol in these situations

3. What does he recommend, IE BCG, Chemo, Radiation, Surgery, etc....

4. What is his skill level, and what hospital is he associated with.

5. If he is part of a team, can you meet the others.

there are many more questions that will be unique & specific to your situation.

You will do this whether you are "Interviewing" a Urologist, Surgeon, Oncologist, or a combination of any of the 3.

Second opinions are helpful in that you will see another's prospective on your situation.

"I have heard that 2 people can witness a crime happening, and will give 2 different descriptions of the perpetrator".

In medicine a lot of what is seen is interpretation, as well as undesputed fact.

It is not something to fear. You have already experienced that. It is worth your time, it only takes about an hour to do, and the benefits surely are worth it. There are no risks in second opinions. Just confirmation, or new information, or in some cases you meet a Dr. that just doesn't fit your bill.

Regardless, I would suggest it as part of what is necessary, not really an option. Granted this is just my opinion. But as I stated in another post:

I would rather be scared to death and find out it was nothing, than the alternative.

Understaging and Overstaging are BOTH problems, without a second opinion how will you ever know?


Karen

Caregiver for my Wonderful Husband Angelo, who has Metastatic Bladder Cancer.

Life isn't about how to survive the storm, but how to dance in the rain.

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13 years 5 months ago #10479 by Rosemary
Karen,

"Understaging and Overstaging are BOTH problems, without a second opinion how will you ever know?"

This statement is very true and you've made some very good points.

My dx jumped from Ta G1 to T1 G3 in a matter of 6 weeks. Even then, when I read the pathology report (the local pathologist wasn't sure himself and sent it to UNC Chapel Hill for a 2nd opinion), it sounds like the local was thinking it could have been one thing or the other, but UNC decided to go with the OTHER. (T1 G3)
Better safe than sorry....

Thanks for the post.

Rosemary

Rosemary
Age - 55
T1 G3 - Tumor free 2 yrs 3 months
Dx January 2006

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13 years 5 months ago #10481 by momof4
Thanks for the possitive feedback.

Another point to mention, is that sometimes the patient doesn't have to be present for a second opinion, (although most Dr.s would like to see you). The reports/pathology/slides etc... can be just be sent to another facility, or Dr. for analysis.

Caregiver for my Wonderful Husband Angelo, who has Metastatic Bladder Cancer.

Life isn't about how to survive the storm, but how to dance in the rain.

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13 years 5 months ago #10487 by Patricia
I think Holly covered this topic quite nicely on another thread.
Secondly with a second opinion you want to make sure you go to someone who is not using the same pathology lab as the first surgeon.
What my second opinion surgeon needed firstly was my slides from the TURB, and all the written reports, CT scans, chest x-rays, everything. And my consultation was in an exam room. Unless they have the slides from the original TURB they can't determine if enough specimen was taken out or is even viable. As it happened in my circumstances pathology said it was a useless sample and i was scheduled for a second TURB within 9 days of my first TURB. This was at a major cancer center by a very major surgeon and it probably saved my life. I also consulted with another surgeon at USC/Norris who reviewed everything and also examined me but did not question the results of Memorial Sloan.
Second opinions are always best from a major cancer center or university affiliated hospital in my opinion.
In the UK there might not be those options?
Pat

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13 years 5 months ago #10489 by momof4
I think that letting the newly diagnosed know that a second opinion is nothing to be scared about and:

That ALL of the tests do not need to be redone UNLESS the second Dr. thinks there is something that wasn't done, or was done incorrectly.

Secondly, You can request that the second opinion can be an informal interview where the results of previous testing is reviewed.

You will at this meeting decide with the new Dr. whether further investigation is needed, and how HE would proceed.

You are once again not obligated to do anything with the second Dr. except hear what he has to say.

It is up to the individual patient as to how much or how little they want to proceed with the "Second" Dr.

They may find out just by the "Interview" that the second Dr. completely concurs with the First.

That they like the credentials of the second Dr. better.

That the First Dr. or Second Dr. was a better listener, better qualified, or they felt like a better fit.

You may also find they have a completely different opinion.

Where and how you procede is the NEXT step. Getting the Second Opinion is the first.

I was trying to let people know that second opinions do not have to be as evasive as initial diagnosis.

I am glad you got a second opinion Pat and that you are here today talking about it. Just proves that it works!

Thanks for your thoughts,
Karen

Caregiver for my Wonderful Husband Angelo, who has Metastatic Bladder Cancer.

Life isn't about how to survive the storm, but how to dance in the rain.

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13 years 5 months ago #10491 by Gene Beane
This is what makes sense to me.......

First opinion, By our initial Urologist, turb stageing
Second opinion, major facility, with surgeon who has done many r/c etc.
2nd turb by this surgeon, of course, how else will he determine if what we have been told is what he believes as well, 2 path reports, 2 different views, whats scary about that. It is comforting to know that the report of having to give up your bladder is not a joke but a realization. A surgeon should never do an r/c on the report of a different Doctor and Pathologist. To avoid any bad info, which happens, be sure. No one ever talked to us other than in an examining room.
Ginger

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