How important do you think the second opinion is?

BTG · August 2010

Hi folks. My wife just got diagnosed with breast cancer for the second time in two years. Last time she was considered stage IIb with no nodes and the tumor responded well to the chemo/radiation. We had a lumpectomy a little over a year ago and of course assumed we were done with this adventure.Last week, she found out there is a new tumor that is about 1.7cm right near where the last lump was removed. The PET scan showed no signs of the cancer having spread. Her breast surgeon and oncologist are pretty much in agreement about doing more chemo followed by a mastectomy. The oncologist asked if she was interested in going to M.D. Anderson in Houston to get a second opinion on treatment options, which I think is mostly a question about which type of chemo and if we should do chemo first or the mastectomy(double). The only reason she is somewhat pushing us in that direction is because my wife is only 37 years old and it was a very quick reoccurrence.We are very comfortable with our doctors and the medical group that the oncologist is a part of is considered to follow the procedures/policies of M.D. Anderson.We are trying to decide how important it is to proper treatment and piece of mind to get a second opinion. For us they are saying we need to plan to be in Houston for 5-7 days. This will be stressful for my wife with being away from our young kids while they start their first day of school and because of the $5000 or so this seems like will be coming out of our pocket.Should be just stick with our current doctors and trust them, or is this a situation where you would want to get the outside consultation? Is M.D. Anderson all it is made out to be?Thanks so much for your thoughts.

Lady_Madonna · August 2010

M.D. Anderson is a fantastic cancer center, however your concerns are understandable. Most insurance will cover a second opinion, some even require it, have you checked with yours? It's also hard to comment on this without knowing where your wife is currently being treated...is it a highly rated cancer center? What type of cancer does she have?... for example, mine has a pretty standard course of treatment, but others have quite a few different options of treatment. I waived a second opinion with my chemo because I did extensive research on my cancer and I knew the standard of care; so if I had gone to UCLA (for example) they would have recommended the same treatment. I read published research reports. However, this is only in my case. I only had a lumpectomy, not a mastectomy and mine was an initial occurance.

I'm so sorry that you and your wife are going through this. I know you want to do everything you can, and it's great that you're comfortable with your current doctors. They can probably tell how widely accepted the standard of care treatment is for your wife's current condition.

Best of luck to you and your wife, she's lucky to have your support.

dhmeiser · August 2010

All I can say is that it never hurts to get somone's Else's opinion who may have a slightly different ideas on treatment. We went to MD Anderson and it was good to hear that our current course of treatment was exactly what the doctors at MD Anderson felt was proper,

My wife was concerned that our current doctor would be upset by us getting a second and a third opinion. When we told her she was delighted as she said another pair of eyes can see things in a totally different light.

dhmeiser · August 2010

All I can say is that it never hurts to get somone's Else's opinion who may have a slightly different ideas on treatment. We went to MD Anderson and it was good to hear that our current course of treatment was exactly what the doctors at MD Anderson felt was proper,

My wife was concerned that our current doctor would be upset by us getting a second and a third opinion. When we told her she was delighted as she said another pair of eyes can see things in a totally different light.

Anonymous · August 2010

A second opinion could be very important, but it should probably be from an institution not directly associated with the doctor(s) from whom you got the first opinion. From what you wrote, the group you are already dealing with follows the recommendations of MD Anderson, so going there for a second opinion might not be worth the cost in money and in missing milestones. Scheduling your consultation a few days earlier or later so you can be there for the first day of school shouldn't be a big issue.

If you need to travel anyway, go to a different area, or go to an doctor associated with, and trained at a different institution. Yes MD Anderson has a wonderful reputation, but so do other institutions, and if you are looking for a second opinion, you are looking for just that, not a rubber stamp, whether the second opinion confirms the currently recommended treatment or offers other options.

BTG · August 2010

Thanks very much for all of the responses. We made the trip to Houston last week as planned and visited with an oncologist at M.D. Anderson. To be honest, it was basically a waste of time and ended up being a very frustrating experience for my wife. I guess we have to take some of the blame for not pushing to get a specific schedule for what we were going to be doing once we arrived. Based on what our home base doctors thought was going to happen as well as what was told to us by a scheduler at M.D. Anderson(as well as some information emailed to us), we assumed we were going to be staying for 3-4 days to have some of the standard test done for a second time and to review all information to make sure we are pursuing the best treatment options.

We drove to Houston Tuesday night with plans to check in at M.D. Anderson at noon on Wednesday and have our first appointment at 1:00. There were a few screws up with registration and such to start with, but the real fun started with the doctor consultation. In walks a guy with no personality at all who spoke choppy English in a very quite voice who was hard to understand. His first question was "how can I help you"? After going over what we were there for(duh!) and what we were looking for, he said he agreed for the most part with what our doctor was suggesting and really didn't see any need for other testing if we weren't going to get treatment or come back for follow up observations at M.D. Anderson. So after 25 minutes we were told that was it, pack up and go home. My wife had spent two days calling doctors to get slides/film/tissue samples, etc and picked all of this up to bring to Houston. We packed up enough stuff for the kids to be away with family for 4 days, etc. Lots of work and stress involved and it was basically all for nothing.

I am trying to stay positive and get my wife to do the same, so my theory now is that we seem to have a pretty standard case and have caught the cancer early again, so we really didn't need M.D. Anderson all that much. The other good thing is that we got home in time to take the little one to his first day of school.

Time to get started and kick some cancer's butt.

NativeMainer · August 2010

I strongly reccomend a second opinion, and from a center or doc NOT affiliated with your current docs. Not that I am questioning the competence of either your docs or the MD Anderson Center, it's just that you will get the same info from both since your docs work with the Anderson protocols. Going to a different center increases your chances of hearing of a newer treatment, or a study that's available, or just a different point of view. I feel that info is very important to making an informed treatment choice. It s alse extremely important to feel comfortable with your treatment team. Since you already feel very comfortable with your treatment team, a second opinion may not be something that is important to you.

One little detail--your local doc can get a virtual second opinion by sending the info to Anderson, and if you ask you'll probably find out that will be or has been done as a matter of routine. The local cancer center here in central Maine is affiliated with Dana Farber in Boston, and most cases are reviewed there as well at in Maine. To get a true second opinion I needed to go out of state. I got very different information at the second opinion and was very surprised as I was assured that the local center/Dana Farber affiliation assured up to date treatment. Turns out it doesn't.

How important do you think the second opinion is?

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