Why should an individual get a second opinion before choosing a treatment option?

Why should an individual get a second opinion before choosing a treatment option?

You know, the reason a patient should get a second opinion before choosing an option is important. And I will hesitate here to say not everybody should get a second opinion before choosing an option. Because if their disease is rapidly progressive and they need to get treatment right away, that's one situation where I would not advocate for getting another opinion. Start treatment, and then maybe modify outside of that.

I think it makes a lot of sense to get a second opinion, especially if the patient has not seen someone with expertise in myeloma, particularly because it is a very complicated field and one that's changing very rapidly.

It's also a field where there are areas where there is not clarity on what the best course forward is. And so getting multiple opinions can really help a patient understand and better define a treatment course for them. That makes sense.

Beyond that, I think it never hurts to get more information and to learn more. You may learn more from the person that you're speaking with. They may have a different take on the disease. They may have a better sense of what your wishes are. But first and foremost, I think the most important thing is someone who has experience with dealing with the disease and understanding the treatment options available.

Because while there may be some subtle differences or even less than subtle differences between approaches, overall, there is a consensus amongst myeloma providers about some general themes. And those general themes should be applied to most patient situations.

People who have expertise are able to bring in all the various things that might be important when considering a patient's options, whether it's a patient's kidney function, the involvement of their bones, their overall functional status, or how able they are to tolerate the therapy.

You can just imagine someone who has treated lots of patients with disease and seen side effects and benefits is probably in the best position when they see someone new to integrate all that information and help someone with making the next step in choosing the next therapy. So I'm a huge advocate for it.

And I tell my patients, if they sometimes come to me and say, is it okay if I get a second opinion? My answer to that is always yes. In fact, I think the only time to be concerned is if a physician is worried about you getting a second opinion, because they should be able to stand by what they're suggesting and recommending.

Again, the only caveat is I have had one rare instance where someone says, I want to get a second opinion, and I say, I think it's fine to do that, but I think you should start treatment first because sometimes folks are either consciously or otherwise delaying the start of therapy. They have fear, they're worried. And by seeing all these folks, they're actually delaying something that they need to do because it could be impacting their quality of life or could lead to a significant problem.

That's the only caveat, but I'm a big fan and advocate for second opinions, especially if someone hasn't seen a melanoma specialist. I think they absolutely should get that input and help in making decisions.

I think probably the easiest way to answer this is that multiple myeloma is not one disease. 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.

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 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 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 have that confidence and not be worried about you getting a 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 broach it with your doctor. You know, if I were in that situation, 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 or concerns with me doing that. I really would like your support in the process of my gathering this information.

I absolutely trust what you're doing, but 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.