Cancer and Second Opinions

I've written about this topic before. I am strongly in favor of getting a second opinion--always. When you receive a cancer diagnosis or any other type of diagnosis that requires invasive medical interventions don't go with only one opinion. I am astonished at how many people will spend the time and effort to investigate grooming products or household appliances, but won't ask a second doctor to look at their scans, tests and lab work.

Recently I had an opportunity to re-examine this advise. Here's my second opinion--I was right, you should seek a second opinion.

An elderly relative was hospitalized for, what turned out to be a "hat trick" of serious conditions. His physician recommended surgery and stressed (more times than I thought was necessary) how high- risk the surgery would be. The physician didn't discuss other options.

When I mentioned that we would be getting a second option the physician got snippy with me. (Gotta love it when a grown man and a specialist, no less, gets snippy.) With condescension dripping from his voice he said that most people didn't find that they needed a second opinion so why did I?

I told him:

• We wanted to hear how another physician would handle these three medical issues
  
• We wanted to learn if there were options other than surgery (so we probably needed to talk to someone other than a surgeon)
  
• We wanted to understand what would happen if my uncle choose to do nothing
  
• We wanted to know if another hospital used an interdisciplinary approach to managing all of my uncle's health issues
• We wanted to have a medical team that was interested enough to ask my uncle to talk about his goals for treatment

I really liked those questions and felt good about bringing them up. And really, I wasn't challenging the guy to a duel, I just wanted another opinion. In fact I had been recruited to be at the hospital to provide just this type of help. So imagine my surprise when I looked around the room thinking that I would see happy relatives nodding their heads in approval and smiling at me and instead saw horror on their shocked faces. The atmosphere in the room got more intense when I heard them tell the doctor that NO--they didn't need a second opinion. They believed him to be the best and they would place themselves in this hands. As I replay it in my mind, I even see then taking a step away from me, crossing their arms over their chests and shaking their heads no, no, no!

My poor relatives were horrified by my chutzpa and looked like they pretty much wished that my parents had left me in a foster home when I was young. They were worried about offending their surgeon. They were so intimidated by the medical setting that they didn't ask questions. No one addressed what my uncle's life would be like if the surgery was not successful. They didn't think that they had the time or energy to go to another doctor to ask more questions. They just wanted to believe that this hospital was the best in the state and that their physician was the best in the world and that they would have the best possible outcome. Period. End of discussion.

Frankly, I was surprised by this physician's attitude. A year ago my husband needed surgery and after consulting with a very experienced and well-thought of surgeon we mentioned that we needed to talk to other surgeons too. He said yes, that was a very good idea. He went on to say that since we should move ahead quickly, if we had any trouble getting an appointment we should call his office to ask them to facilitate the process. Now that's what I'm talking about!

In trying to help I was just raising blood pressures. And yet, it was impossible for me to just let it go. So I waited...and made an appointment for a second opinion. I didn't know what I was waiting for, but I thought that reason and good common sense couldn't be kept at bay for too much longer.

The next week more problems developed that forced my uncle to make a quick appointment with his family doctor. That's where he received a second opinion-- of sorts. His Family Medicine doctor reviewed the hospital notes and voiced concerns. He outlined how risky the surgery would be and how long and involved the recovery would be. He said that even if the surgery went well the other two serious conditions that my uncle was living with would still be present. The surgery might not make his life any better. He encouraged my aunt and uncle to think about they wanted in terms of quality of life and to discuss that with other doctors. He said--get a second opinion.

My uncle is going to get a second opinion. Thank goodness.

Any physician, clinic or hospital that discourages getting a second opinion is suspect in my book.

There are no guarantees. Even after considering the information gained from a second or third opinion things may not turn out well for my uncle, but at least we did all that we could to understand what we were up against.