When Diagnosed With Cancer, a Second Opinion Can Have a Big Impact on Treatment.

February 26, 2019 in Second Opinion  •  By Miles Varn, MD

If you have been diagnosed with cancer, you may feel as if you need to start treatment as quickly as possible. For most types of cancer, however, there’s no need to rush to begin treatment immediately and there are benefits to taking the time to seek a second opinion on your diagnosis and treatment plan in many cases. A second opinion can give you peace of mind by confirming your diagnosis and treatment choice, offering other treatment options the diagnosing physician may not have suggested, or completely changing your diagnosis and/or treatment recommendation.

There are a number of studies that looked at second opinions for people diagnosed with cancer and found that receiving a second opinion from an experienced specialist had a significant impact on diagnosis, treatment, or both. A recent study conducted at the Medical University of South Carolina (MUSC) found that the diagnosis was changed for 43% of women with breast cancer who were referred for a second opinion at a National Cancer Institute-Designated cancer center with a tumor board.

The study focused on women who were diagnosed at another hospital, then referred to MUSC for a second opinion. The researchers compared the radiology, pathology, and genetic testing reports from the outside hospital with reports developed after the cases were reviewed by MUSC’s tumor board. Nearly 23% of the patients had additional cancers diagnosed in one of the breasts or a lymph node in the armpit. The pathology review changed in 20% of the cases. And 16% of the patients who met guidelines for genetic testing by the National Comprehensive Cancer Network had not been referred for testing that could affect which type of treatment they received.

Other studies also reaffirm the value of a second opinion from an experienced specialist:

  • One study focused on PET/CT scans of people diagnosed with diffuse large B-cell lymphoma. Researchers found that in 36% of the cases studied the second opinion resulted in a change in staging, which can affect the choice of treatment.
  • Another examined the effects of a second opinion on biopsies from a specialist at a comprehensive cancer center for patients with bladder cancer. In that study, the biopsies were initially performed and read at a community hospital. When a genitourinary pathologist at a comprehensive cancer center reviewed the biopsies, 24.7% of the biopsies reviewed had a change in pathology reading, including changes in the grade of tumor and stage of cancer, with 15.8% of these patients receiving a different treatment recommendation, 11.8% of which were major changes.
  • In a study of patients with orthopedic cancers, review of MRI studies by musculoskeletal radiologists found a 22.2% rate of clinically significant difference that had the potential to change the original diagnosis between the first interpretation and the second opinion.

The takeaway? Seeking a second opinion from a specialist who has extensive experience in the diagnosis and treatment of the cancer you face can provide a more accurate diagnosis and appropriate treatment plan.