Second Opinion In Cancer Care – Making It A Constructive Process

This article discusses how to make the best use of a second opinion in cancer care.

A second opinion is defined as seeking an independent opinion on either diagnosis or treatment by an expert in the same field as the specialist who gave the initial opinion.¹  While there are other sources of information for people with cancer, there is no substitute for the expertise and experience of a professional medical expert.  Cancer is among the illnesses for which a second opinion is most commonly sought.  The second opinion is sought with the intention of returning to the first physician; otherwise, it is called a “tertiary referral.”²

Obtaining a second opinion should be a constructive process for all parties concerned – the patient and their family, the primary medical team, as well as the doctor/team from whom the second opinion is sought.

For the patient and their family, the potential benefits from a second opinion could include

• Reassurance that their diagnosis is correct and plan of treatment is appropriate
• The satisfaction that no effort was spared to obtain the best outcome
• Address any gaps in information after the primary consultation
• Additional insights into the diagnosis or treatment process
• Facilitate decision-making especially if there is more than one option for treatment
• Opportunity to get an opinion from a larger/more experienced team (eg a cancer center or a tumor board)

A second opinion is not about finding flaws in the original diagnosis or treatment plan.  Many medical experts have their own minor modifications and variations in treatment protocols – it is like different chefs having their own recipes for the same dishes.  This is nothing to worry about, and the doctor should be able to clearly explain the reason for this variation.  But, if the second opinion differs greatly from the first, it is important to talk to both the doctors to understand the reason for the difference, and whether there is any communication gap.

The patient should not feel that they may hurt the primary doctor’s feelings or antagonize them by taking a second opinion.  In fact, an experienced and mature doctor would welcome a patient’s decision to seek another doctor’s opinion.

Sometimes, people have difficulty in coping with a diagnosis of cancer, and accepting the course of the treatment.   In this situation, seeking another opinion should not become a process of seeking multiple opinions hoping someone will tell you what you prefer to hear.

To summarize, for a serious illness like cancer, a second opinion could provide many benefits – it is important to approach the process in a positive and constructive way.

1. Hillen, M. A., Medendorp, N. M., Daams, J. G., & Smets, E. (2017). Patient-Driven Second Opinions in Oncology: A Systematic Review. The oncologist, 22(10), 1197–1211. https://doi.org/10.1634/theoncologist.2016-0429
2. Zorginstituut Nederland. Second opinion in de zorgverzekeringswet, 2015. Available at https://www.zorginstituutnederland.nl/publicaties/standpunten/2015/01/06/second-opinion-in-de-zorgverzekeringswet.