Second Opinions

Many people hear a diagnosis of cancer and think they must make a decision and jump into treatment the next day. While this can be true in certain types of lymphoma and leukemia or emergency situations, for most patients, a few weeks to get another opinion and weigh your options is realistic. Believe it or not, there is no cookbook to follow when treating a cancer and you can encounter different treatment options for the same patient, even within the same cancer center. Every patient is different and each treatment plan should be tailored to that patient’s situation.

What is a second opinion?

• A visit with another cancer care specialist to review your specific case. This can include reviewing pathology slides and reports, radiology and lab results, and other information about your cancer diagnosis.
• The provider will also review the treatment options you have been given and may provide alternatives.

Why should I get a second opinion?

• A second opinion gives you an opportunity to explore all options for your cancer treatment as well as meet other providers. You need to feel comfortable with the team that will coordinate your care.
• A second opinion can help you learn more about your cancer and possible treatments – think of it as an educational session.
• Second opinions are particularly helpful in the case of rare or unusual cancers.

How do I find another provider to give me a second opinion?

• Start with the provider who gave you the diagnosis. Healthcare providers have vast networks of colleagues locally and around the country.
• Ask other people who have the same type of cancer who they see for their medical care and how they feel about their team. Other patients can share their experiences with their cancer treatment teams—but remember not everyone wants the same things from their providers. One person may like someone to be blunt and to the point, while another may want someone to hold their hand every step of the way.
• Your insurance company can also provide you with in-network referrals for other cancer care specialists.
• The National Cancer Institute maintains a list of cancer treatment centers that are designated “comprehensive cancer centers.” These centers are leaders in cancer research, cutting-edge cancer care, and clinical trials.

Will a second opinion be covered by my health insurance?

• A second opinion is a specialist appointment. You will be responsible for co-pays and co-insurance which is part of your insurance coverage. And yes, you can get third or fourth opinions as well.
• That being said, not every provider will be in your insurance company’s network of providers, meaning you may be in “out of network” coverage. This can be significantly more expensive.
• Repeat scans and lab work MAY NOT be covered. Be sure that any tests are pre-certified and/or authorized before you have them done to avoid a surprise bill.
• Many centers will take your radiology scans from another institution and have them “read” by their own radiologist. They can also bill you for this.

Will my current healthcare provider be upset if I get another opinion?

• Your healthcare providers want you to feel informed and comfortable with your plan of care, regardless of where you have care or who is your oncologist. They do not take this personally. You shouldn’t feel guilty, anxious, or worried about advocating for the best plan of care.

What if I want to switch care to the other provider after my second opinion?

• This is fine. If your gut says switch to this person, do it. It’s important that you trust your cancer care provider – and their team - and can communicate well with them about your treatment, side effects, and life with and after cancer.

I live in a rural area, far away from a comprehensive or academic cancer center. Can I still get a second opinion on my case?

• For some people, it may be worth taking a trip to a large center once for an opinion.
• Many of these places will provide guidance to your local oncologist on treatment.
• Some centers offer second opinions by phone or online; you may be billed for these consultations.
• You will be responsible for out-of-pocket expenses like travel, lodging, and meals when getting that second opinion. There may be travel assistance available. Ask your oncology social worker or navigator for referrals.

Can I get a second opinion on the pathology report and diagnosis?

• Yes. Large centers perform second opinions of pathology materials (slides and reports) all the time.
• You may be able to find a center that specializes in your tumor type. If you don’t know of an expert center, try one of the major cancer centers in the US where they have a lot of experience in pathology review. Call the pathology department of that institution and ask how to have your slides reviewed for a second opinion on the diagnosis.
• This can usually be done by mail or electronically - so geography need not limit where you can send the materials.
• There is usually a fee for having slides or tissue reviewed by an expert. Insurance companies may reimburse part, if not all, of these fees. Contact your insurance company before sending your slides to check on reimbursement, and if an out-of-network review is permitted.

It may take some work to coordinate a second opinion, but in the end, you will have peace of mind that your case has been reviewed by multiple healthcare providers who have offered the best options to you for your cancer treatment.