counseling and resource center for cancer patients - serving the east end free of charge

Second Opinions

Even after you have selected your doctor or medical team it may be important to get a second opinion. Volumes of new information on the latest cancer developments are produced every day. Your doctor may not be aware of all of them. Checking in with another expert gives you the opportunity to validate your doctor’s diagnosis and recommended
treatment approach or to identify a new perspective with new options and alternatives that you may not have known were available.

Challenge: I’m interested in getting a second opinion. What steps should I take?

Solution: Obtaining a second opinion is a common practice, so your doctor should be very comfortable with the request. Your doctor should provide the referral doctor with all of your medical records and any other pertinent information he/she might need to evaluate your situation.

In most cases, it is up to the patient to retrieve their medical records from their referring physicians. Do not be afraid to ask for this information, it is afterall, your medical information. Remember to read your insurance policy and check to confirm that a second opinion will be covered. In some cases your insurance company may require a second opinion and may
require that you see someone in its network.

Get a second opinion when:
• You want to be sure you have explored all options.
• You think there may be another treatment available.
• Your insurance plan requires it.

TIP #4 What is a "Comprehensive Cancer Center"?

The National Cancer Institute or NCI spends billions of dollars each year on cancer research. Some of the largest grants go to medical facilities that the NCI designates as Comprehensive Cancer Centers or CCCs. There are 39 of them in the U.S. and they are noted for combining high quality clinical care with superb academic research.

There are four CCCs in New York State and two of them are in New York City. One is Memorial Sloan-Kettering Cancer Center (212-639-2000) and the other is the Herbert Irving Comprehensive Cancer Center of Columbia University(212-305-5201).

Due to their deep roots in cancer research,CCC’s tend to be excellent places to go for second opinions or to learn about the latest clinical trials.

Finding the Best Doctor for a Second Opinion
Many cancer patients seek second opinions to confirm their diagnosis and treatment plan. Usually, a second opinion will probably not provide an entirely different diagnosis – for example, concluding that there is no cancer present. Instead, most second opinions tend to focus on different treatment options, some of which are “cutting edge” and occasionally the subject of clinical trials.

From this perspective, the “best” doctor for a second opinion probably will have a scholarly bent and will be affiliated with a research-oriented hospital such as a CCC. Of the 39 CCCs in this country, there are some facilities that are also members of the National Comprehensive Cancer Network or NCCN. The NCCN institutions are often portrayed as the “Cadillacs” of cancer care hospitals.

A sensible criterion for picking a second opinion doctor would be to identify a doctor who is on the medical staff or faculty of a CCC institution which is also a member of the NCCN. Within the East Coast area, four institutions meet that definition; Memorial Sloan-Kettering Cancer Center in New York City (212-639-2000); Dana Farber Cancer Institute in Boston (617-632-4266); Rosewell Park Cancer Institute in Buffalo (716- 845-5772); and the Kimmel Comprehensive Cancer Center at Johns Hopkins in Baltimore (410-955-8964).

You can find a list of CCCs on the NCI’s website (www.cancer.gov) and the NCCN’s website (www.nccn.org) which lets you pick a doctor by specialty. It will provide background information on his/her field of work plus a phone number.

Working with your Local Hospital on Arrangements for a Second Opinion.

Many cancer patients who originally were being treated at a hospital on the East End of Long Island seek a second opinion from a major Comprehensive Cancer Center.

Cancer patients should realize that it can take several weeks to get a doctor’s appointment for a second opinion. And, before the appointment, the doctor needs to receive information already acquired, which typically includes (1) biopsy pathology slides and reports; (2) radiology files and reports, such as x-rays and CT scans; and (3) any other relevant physician reports.

If chemotherapy or radiation therapy has already started, then summaries of treatments to date are necessary. Some cancer centers will not see you if you are currentlty undergoing treatment.

The staffs at local hospitals tend to be very cooperative, but the cancer patient or caregiver still has a lot of material to organize in connection with seeking a second opinion.

Be your own best advocate!

Tip #5 The Option of Memorial Sloan-Kettering Cancer Center

Memorial Sloan-Kettering is the largest hospital facility in America dedicated exclusively to cancer, ie, diagnosing cancer, treating and curing cancer and undertaking clinical trials and other research to find the causes (and sometimes the cure) for many types of cancer. It is an extraordinary resource.

“Memorial” (as the hospital is commonly known) has several facilities in Manhattan as well as new “satellite” offices on Long Island. See Tip # 6.

The fact that the Memorial facilities are accessible expands the medical options for cancer patients on the East End. Understanding the full range of medical options is an important “life skill” for cancer patients and their caregivers.

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