With so many options available, at what point should a patient consider getting a second opinion?

At what point should a patient consider getting a second opinion?

I think there's great value in seeking a second opinion. I always encourage that. I think each and every patient should feel very comfortable with, first of all, with their doctor, of course, but also with the decision in, each and every kind of time point that there needs to be a decision in the disease course. So those time points can be at the very start.

So the initial therapy and then a transplant, whether to do upfront transplant or whether to do delayed transplant and then at time of disease progression and early or late progressions because there we have so many treatment options and it's really both experience and art and patient preference to what to choose for each and every patient. So I think that's a very good idea to get a second opinion.

I mean, I think it's always helpful to seek a second opinion. I think it's tricky. Of course. It's, I think it's important for patients to seek an opinion from someone who sees lots of myeloma patients and really focuses on, the myeloma treatment landscape. It's such a complex landscape now, which is really a wonderful thing, because we have so many available options for our patients.

so in many ways, it's a good thing. But also for someone who doesn't primarily focus on myeloma, it can be confusing. And they, you know, that individual may not always be fully aware of what sort of like the latest, data is the latest approved drug is. And so I think that's very important. in that sense, to seek out a second opinion from someone with, significant expertise in the disease.

It's been shown that people who get treated at, institutions or, seen at institutions that treat lots of myeloma, do better. and I think that's one of the reasons why. Do you need to seek out multiple different opinions from people with expertise at, like, the major centers? I guess that's a patient preference. But, you know, I would say that at least one is important.

I think as myeloma therapy becomes more complex, I think it is important to get, different opinions when you're at a point of making decisions about what the next line of therapy might be. I truly believe, again, that, myeloma therapy must be very individualized. and for that, there may be difference in opinions amongst different people about what the next best thing might be for an individual.

that doesn't make one option right and the other one wrong. I do think, however, it is important to get all the information and get thoughts from people, about why, those rational combinations are being recommended for an individual, even if they differ. So it's important from a patient's perspective to understand the thought process that goes in when choosing lines of therapy.

Because we do, you know, think of myeloma as a marathon. So if we are, potentially recommending a very active combination, let's say in the first relapse, we also think about what might be available, for the patient in the future if they relapse on this. recommended regimen. So it's important to think not just in the moment, but also, several steps ahead to make sure that we are not, potentially eliminating certain options, for patients that may benefit them, let's say, at a later time.

So I tell people they should think about getting a second opinion every time they feel like they, you know, want to get more information. And that by no means is a, you know, a negative, factor on their local physician or their primary oncologist. It really just comes down to your own peace of mind and making sure you fully understand all the medications that we have available and why we might be recommending a particular combination or not.

And the second thing I will just say is any time, you know, consideration is being given for a particular clinical trial, let's say that's not available at your local facility. I think that's another, time to explore at major academic centers to see what is available at that moment, for an individual which may be different, because it is in clinical trial format than what might be recommended at the primary oncology, with the primary oncology team.

How do I seek a second opinion without offending my doctor?

I think the best thing is to be honest. And you can also bring in your doctor and get and engage them and say, I really like you. I would like to get a second opinion. Is there anyone that you could recommend? And can we have all have a discussion together? I think that's a great way. And just be very honest and very straightforward, because this is so common and doctors the really the vast majority are for this.

So I've almost never come across hard feelings in any way.