How do I get a Second Opinion (cancer)?

Posted by slapshotmary @slapshotmary, Dec 27, 2021

I know this sounds stupid, but how do I get a second opinion? I need to have a second opinion on the treatment that has been offered to me. It just seems like my oncologist tells me good information and then just does it. I have to stop and ask for think about it. I just feel like I am being ambushed and he doesn't always answer my questions directly. He doesn't give me time to think in an appointment. Any advice or information will be greatly appreciated.

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@colleenyoung

@gisellef, you're right. Mayo Clinic found similar findings in a study about second opinions

- Mayo Clinic researchers demonstrate value of second opinions https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-researchers-demonstrate-value-of-second-opinions/

The study conducted at Mayo Clinic found that 88 percent patients who visited Mayo Clinic for a second opinion were found to have their initial diagnosis changed or modified as a result of a second opinion.

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I am not surprised. Mayo has an excellent reputation and is a very solid option for anyone looking for a second opinion.

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The local hospital that I couldn't get interested in doing a LC screening says it has COC Accredidation. That means it's accredited by American College of Surgeons Commission. It specializes in breast surgical treatments, and lung, colon, abdominal and urologic surgery. I'd seen a pulmonologist there for some time said they wouldn't have done sugery on me. I don't know why. I'd done well on the Pulmonary Function Test prior to the VATS surgery at the teaching hospital. I'd made an appointment there a couple years after I'd been in a traffic accident. I liked their pulmonary staff. Teaching hospitals see more patients from diverse populations. When I was told I had the spiculated nodule, the Pulmonologist made appointments for the CT biopsy. The Oncology Surgeon, and Oncology Radiologist were scheduled. The PET and brain MRI were scheduled. All this was within one week. The docter who taught VATS surgery did an excellent job. He had great credentials.
I could have made an appointment at Mayos, but I felt they did a good job.

I'd told that surgeon that the hospital at home wouldn't have offered me surgery. He didn't say anything. I have Medicare, and supplement plans. I think the problem was that it was lung cancer. The local hospital is strapped financially with walk-ins, and Medicaid/Medicare patients. The teaching hospitals are not bad places to get a diagnosis.

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@colleenyoung

@gisellef, you're right. Mayo Clinic found similar findings in a study about second opinions

- Mayo Clinic researchers demonstrate value of second opinions https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-researchers-demonstrate-value-of-second-opinions/

The study conducted at Mayo Clinic found that 88 percent patients who visited Mayo Clinic for a second opinion were found to have their initial diagnosis changed or modified as a result of a second opinion.

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Yesterday ( January 17), I had my final Chemo #6 infusion for bladder cancer...

I also met with my oncology doctor, and the news is good there. They've decided that I'm good candidate for bladder and prostate removal surgery vs. radiation treatments. I had swollen prostate surgery many years ago, however no cancer cells had ever been detected there.

My cancer is at stage 3, meaning tumors have not metastasized (spread) to other organs.

According to the following link, provided by the "American Cancer Society," after bladder tumors reach stage 4, the outcome is less predictable. Tumors there are more difficult to detect, and may have even started penetrating the bladder's outer wall.

https://www.cancer.net/cancer-types/bladder-cancer/stages-and-grades

On February 7 I'm scheduled to meet with the oncology team to schedule surgery. In the meantime they'll be working out the details.

There are two options for bladder removal surgery, one with a long abdominal incision for placement of an external Stoma. The other option being a few small incisions with surgery performed robotically, via the following method of "laparoscopy."

https://my.clevelandclinic.org/health/treatments/21094-robotic-cystectomy.

In discussing with the VA doc yesterday, he wasn't sure whether surgery would be performed at the VA hospital, or at the adjacent U of W research center.

If approved, and I'm given a preference, it will likely be laparoscopy, since it seems to be less risky, and offers a shorter recovery time.

With either surgery method much of the final results may depend upon surgeon skills, with a little luck thrown in.

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@gordy6898p

Yesterday ( January 17), I had my final Chemo #6 infusion for bladder cancer...

I also met with my oncology doctor, and the news is good there. They've decided that I'm good candidate for bladder and prostate removal surgery vs. radiation treatments. I had swollen prostate surgery many years ago, however no cancer cells had ever been detected there.

My cancer is at stage 3, meaning tumors have not metastasized (spread) to other organs.

According to the following link, provided by the "American Cancer Society," after bladder tumors reach stage 4, the outcome is less predictable. Tumors there are more difficult to detect, and may have even started penetrating the bladder's outer wall.

https://www.cancer.net/cancer-types/bladder-cancer/stages-and-grades

On February 7 I'm scheduled to meet with the oncology team to schedule surgery. In the meantime they'll be working out the details.

There are two options for bladder removal surgery, one with a long abdominal incision for placement of an external Stoma. The other option being a few small incisions with surgery performed robotically, via the following method of "laparoscopy."

https://my.clevelandclinic.org/health/treatments/21094-robotic-cystectomy.

In discussing with the VA doc yesterday, he wasn't sure whether surgery would be performed at the VA hospital, or at the adjacent U of W research center.

If approved, and I'm given a preference, it will likely be laparoscopy, since it seems to be less risky, and offers a shorter recovery time.

With either surgery method much of the final results may depend upon surgeon skills, with a little luck thrown in.

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Robotic surgery known to be more precise with less downtime. I would always choose this if offered the option.
Best of luck for an excellent recovery.

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Thanks for your reply and encouragement....

If offered, I definitely will go with Robotic surgery.

If the VA hospital doesn't have the equipment, chances are the adjacent U of W research facility does. It's a huge complex, and is recognized as being one of the best and most advanced medical centers in existence.

Here's a photo, not of myself, but my favorite traveling machine.....

I can go out to my hangar on a winter day here in Rockford in early morning to shovel snow from the ramp. By mid-afternoon I'm in Phoenix, walking around in a flannel shirt.

To simplify legal procedures in the event of my death, a few years ago I transferred titles to my older son Alan. He's also an "Airplane Nut." Until I'm in full recovery, 2 planes are in his hangars out in Nebraska. One being an experimental "BD-4" which I built and test flew almost 20 years ago. Another plane, a 1946 Cessna 140, is in a friend's hangar out at Stellar Airpark in Chandler, Arizona awaiting restoration.

https://www.flightaware.com/photos/view/8954410-7dbde11323c6c2ac88ce26a1bceac3027851e774
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@gordy6898p

Thanks for your reply and encouragement....

If offered, I definitely will go with Robotic surgery.

If the VA hospital doesn't have the equipment, chances are the adjacent U of W research facility does. It's a huge complex, and is recognized as being one of the best and most advanced medical centers in existence.

Here's a photo, not of myself, but my favorite traveling machine.....

I can go out to my hangar on a winter day here in Rockford in early morning to shovel snow from the ramp. By mid-afternoon I'm in Phoenix, walking around in a flannel shirt.

To simplify legal procedures in the event of my death, a few years ago I transferred titles to my older son Alan. He's also an "Airplane Nut." Until I'm in full recovery, 2 planes are in his hangars out in Nebraska. One being an experimental "BD-4" which I built and test flew almost 20 years ago. Another plane, a 1946 Cessna 140, is in a friend's hangar out at Stellar Airpark in Chandler, Arizona awaiting restoration.

https://www.flightaware.com/photos/view/8954410-7dbde11323c6c2ac88ce26a1bceac3027851e774

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Hi Gordy:
You have a lot of wonderful reasons to fight and beat this thing. I hope you are able to find the best care available to you -- preferably at an excellent cancer centre. It is worth the extra time and effort. I expect that you will be back flying soon.
All the best.

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Thanks for your encouragement...........

I live to fly, and hope to get back in the air ASAP.

Here's a shot of my experimental "BD-4." I finished building and test flew it in 2006. My son Alan did the finish work... painting, avionics, leather interior, etc.

I transferred title to Alan in 2008.

https://www.flightaware.com/resources/registration/N33AW

As soon as I'm up and about, I plan to fly it out to Arizona. A close friend has a commercial cabinetry company at Stellar Airpark in Chandler, so his hangar will be a temporary home.

Here's another shot... high over the plains of Nebraska, Alan at the controls.

https://www.flightaware.com/photos/view/8954410-112c27f9a34c2a6110bf2b6664f066ce7d25f3b6/aircrafttype/BD4
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@gordy6898p

Thanks for your encouragement...........

I live to fly, and hope to get back in the air ASAP.

Here's a shot of my experimental "BD-4." I finished building and test flew it in 2006. My son Alan did the finish work... painting, avionics, leather interior, etc.

I transferred title to Alan in 2008.

https://www.flightaware.com/resources/registration/N33AW

As soon as I'm up and about, I plan to fly it out to Arizona. A close friend has a commercial cabinetry company at Stellar Airpark in Chandler, so his hangar will be a temporary home.

Here's another shot... high over the plains of Nebraska, Alan at the controls.

https://www.flightaware.com/photos/view/8954410-112c27f9a34c2a6110bf2b6664f066ce7d25f3b6/aircrafttype/BD4

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Hi Gordi:
That is truly awesome. I love to travel by plane but honestly I can’t imagine being in the pilot’s seat nor in an aircraft where you feel every bit of turbulence. It must be exhilarating but in a scary way. I try to fly with Delta, when I travel in the US as one of the really nice things they do is to have the pilot stand outside the door of the cockpit to greet passengers on the way out. That really makes the trip experience personal for me. Arizona is a great place to get away from everything. You have a great plan in place.
Thanks for sharing.

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@gisellef

Hi Gordi:
That is truly awesome. I love to travel by plane but honestly I can’t imagine being in the pilot’s seat nor in an aircraft where you feel every bit of turbulence. It must be exhilarating but in a scary way. I try to fly with Delta, when I travel in the US as one of the really nice things they do is to have the pilot stand outside the door of the cockpit to greet passengers on the way out. That really makes the trip experience personal for me. Arizona is a great place to get away from everything. You have a great plan in place.
Thanks for sharing.

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Turbulence can be a problem at times. But, as with most such things, you learn to adapt.

The best response is to reduce airspeed for a smoother ride. Planes appreciate that... severe hammering by turbulence takes a toll on their structure. There have been more than a few fatal accidents over the years when pilots flew into, or too close to, severe weather.

If you have a powerful enough plane, what usually works best for myself is to climb to a higher altitude, where the air is usually smoother.

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in reply to slapshotmary @slapshotmary, Dec 27, 2021 -getting a 2nd opinion.
I am with Honor Health system but can go anywhere-- I had a first opinion before getting my initial biopsy- and just the mammogram of a highly suspected large mass in my right breast to hear his recommendation for a double mastectomy for best look/option for clothing. It so blew me away that I started asking around on same question- how to get 2nd opinion without causing high irritation etc. It is not easy- especially for women to feel they are going to make waves. Remember- not only do you have a right to get a 2nd opinion- in 5 yrs- the initial doctor will be out of the picture and won't even remember who you are. You only have your body once and frankly, it is expected now in these times- thank goodness- that getting a 2nd opinion is not only a good idea but welcomed. If the same as the first it gives you more confidence and information and if different than the 1st- it gives you confirmation that you were right in questioning the initial results. The other is that despite the rush to get surgery - research shows that with most breast cancers - they are slow growing and there is NO RUSH. This was good because they found my surprise cancer in October (breast awareness month- not the best time to try and get action) I couldn't get in until November anywhere and when I did- I was looking at January for surgery. But it was all good.
Take your time and get that 2nd opinion and as many tests as necessary to confirm that opinion. The most important is that you really feel great about the doctor /team you will be working with. I researched /asked around and specifically was trying to get a 2nd opinion from a specific oncology surgeon and an oncologist/breast cancer specialty. I ended up at Mayo and could not have felt better about getting that 2nd opinion and the team at Mayo I ended up with. I wish you the best and support your courage to step out for yourself and don't feel ambushed.... it's your life.

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