How and why should I obtain a second opinion?

When and why should I seek a second opinion? Will I be offending my doctor by getting a second opinion?

Second, opinions are very important in myeloma because that's because, as I've said earlier, not everything is hard and fast and definite when it comes to our cancer. Second, opinions should be welcomed by your doctor.

You should get a second opinion anytime there's a major decision to be made. If you have a relapse, if it's time to change treatments, it's really a good idea to get a couple of opinions on the next treatment plan that you should have.

And you won't offend your doctor if you get that second opinion. In fact, any good doctor would welcome another doctor looking at their plans, looking at their treatment schedule and a good doctor who can help you get that second opinion will actually even help you get it. They can arrange it for you. They can get all of your records transferred to the second doctor, your first doctor should be quite helpful and should never be offended when it comes to getting the opinion of another doctor.

I think you should get a second opinion as soon as possible, and you might find that a third opinion and a fourth opinion would benefit you down the road. Most doctors I know, local oncologists really appreciate an educated patient and may very well help the patient find a specialist in your area.

But if for whatever reason, your doctor seems offended, I honestly wouldn't hesitate to change doctors. I think it's awfully important from your standpoint, the patient, to do whatever is best for you. And have your local oncologist support you in that.

I think that's, an important that, that you would get a specialist to be part of your, your team. The second thing is if, in fact, you aren’t comfortable with the individual that you're with, well, let's go back just for a second and say.

So you go to a local doctor, sends you a local oncologist. A local oncologist sees maybe one, maybe two, myeloma patients in a year's time, if lucky. And as a result, he really doesn't have the expertise. You know, for example, if you go to a place like MD Anderson, Dana-Farber, you know, Levine Cancer Institute or UAMS, what you're going to find is they have thousands of patients that they're dealing with.

And anything that can go wrong, they've seen and they've been able to, resolve those issues.

I think probably the easiest way to answer this is that multiple myeloma is not one disease. and as Doctor Fonseca has famously said, this is the multiple myeloma. This is a disease that, is different in every individual. And for that reason, each individual requires an individualized approach.

And these days, in order for somebody to get that kind of recommendation, you need to see a multiple myeloma specialist, somebody that deals only with this disease. And that is because everyone's disease and everyone's situation is unique. so it behooves that person to try to at least get an opinion to make sure that the journey that they're starting on is the right one for them.

Sometimes it's hard to get a second opinion. And sometimes it's hard to physically get an appointment with with a myeloma specialist. But I think that anyone should get a second opinion whenever they want to do it.

Myeloma is complicated. The diagnosis usually comes as a surprise to individuals, and it's frightening to be told that you have a diagnosis that can't be cured.

So I think that it's really important that an individual patient and their caregivers feel comfortable with the information that's been presented, that they have a relatively good understanding of where their disease is, and that they understand what treatment choices might be present.

When should you seek a second opinion?

I think that if a treatment change is required, it makes sense to consider a second opinion, particularly if there's a particular type of treatment that a patient or their family or caregivers might have heard about and been interested in. And they're not hearing about it from the team that's primarily caring for them.

I also think that if there is uncertainty that a patient feels about whether the care that they are receiving seems consistent with what they're reading about, then it would make sense for them to to try to get another opinion.

What is the process of getting a second opinion?

The process of getting a second opinion, has changed since Covid. Telemedicine, does exist, but there have been relatively recent tightening of the rules about where a patient and physician need to be in relation to each other to do a telemedicine visit.

So some, physicians and some institutions have licensure outside of the state in which the physician, practices. And if that's the case, then sometimes a virtual visit will be will be a possibility.

In other cases, the patient does need to travel to go and and receive a second opinion. And that can of course be costly.

The how to obtain a second opinion, I think that organizations such as HealthTree and other organizations where patients are speaking with each other can be very useful. They can understand which centers, seem to be communicating with patients in a way that they, are interested in learning more about.

And honestly, what we do is we receive second opinion requests. We look at where a patient physically is. And if it seems like travel to our state would be very burdensome. We sometimes just try to help them find out where they could go. That might be a little bit of an easier commute.

Will I offend my doctor by seeking a second opinion?

I know that it is a concern amongst patients that they might offend their physician or somehow be a sign of, you know, disrespect to their physician. I feel strongly that, patients need not worry about that again. If it turns out that that really is an issue. It probably makes sense to get a second opinion anyway, right?

And I can say personally, that, you know, one has to have that sort of confidence in their recommendations and decision making that would, stand up to someone else's opinion and advice. So you want your doctor to to have that confidence and not to be worried about your, getting second opinion and I, cannot remember any colleague that I've had who has had any significant concern or issue with a patient getting a second opinion.

So I encourage people to do it. I encourage people to feel confident about doing it. I do think it might be important for how you approach it with your doctor. You know, if I were, in that situation, I would I would cage it in terms of saying things like, I want to make sure that I'm covering every possible angle, and I'm, interested in, ensuring that people with different perspectives might be able to weigh in so that I can put all of this together. I hope that you don't have any issues of concerns with me doing that. I really would like your support. and in the process of my gathering this information. I absolutely trust what you're doing, but that my doing that has nothing to do with my lack of trust. It more has to do with my interest in seeking knowledge and understanding perspectives.