A Helping of Second and Third Opinions

My particular case of colon cancer is pretty standard. Upon diagnosis, I had a standard colon resection without complications. I had standard metastasis to my lungs. And after six-plus years and more than 150 rounds of treatment, I am still on the standard therapies available for my disease. But I know the standard therapies remaining for me aren't curative, and are only intended to provide stability. If I want to have hope in doing anything more than buying time, I needed to consider clinical trials and seek out for opinions for the direction I could take my care.

While slowly warming up my search for a trial, results of a study were released that showed successful re-challenging of patients with a targeted therapy on which I had recently had a successfully long run. The evidence being that the tumor cells that mutated to become resistant to the therapy can mutate back to become receptive again after a prolonged break. Not only had my cancer cells been initially receptive to this therapy, I had just finished up the designated prolonged break as indicated by the study. My interest was piqued!

Knowing I was about to visit an oncologist at a nearby NCI-designated comprehensive cancer center to discuss a trial, I planned to ask for his thoughts on revisiting the targeted therapy, based on the study results just released. He blew off the idea without much rationale, and recommended I continue my treatment by starting the next available drug on the list. Considering his position as not only an oncologist specializing in colorectal cancer, but at one of the most recognized medical institutions in the world, I didn't take his opinion lightly.

The following week, I sat in the office of another oncologist at another NCI-designated comprehensive cancer center to talk about a trial for which he was recruiting. Before we took any next steps, I asked him what he recommended, or more importantly, what he would do if he was in my shoes. Much to my surprise and satisfaction, he brought up the recent study and recommended I revisit this targeted therapy, given the positive study results. I was pleased to hear him contradict the oncologist from the week before, and he confirmed the direction I actually wanted to go in with my treatment.

Within a single week, I had sat in the offices of two very accomplished oncologists at two highly recognized cancer centers and was given conflicting advice. Fortunately, I understood the study, the targeted therapy, my response to it and the wisdom in re-challenging my tumors with it based on these study results. I took this information back to my primary oncologist at my own NCI-designated comprehensive cancer center, who was all too agreeable to revisit the targeted therapy given the information I presented.

The moral of the story is you can never have too many opinions, and just because an opinion comes from a highly respectable source doesn't mean it's your best option or the right direction to take your treatment plan. My third opinion put me on the path to revisiting a targeted therapy, and with an almost instant drop in my CEA (carcinoembryonic antigen) level after just two rounds, it was evident that it was the right decision to make. A third opinion ultimately bought me more time — more time for new trials to open, more time for current trials to get more results, and more time to defy the odds of living with metastatic disease. And as anyone impacted by potentially terminal cancer knows, time is everything.