The Pros and Cons of Seeking a Second Opinion In Cancer Treatment

An expert explains the importance of getting a second opinion during a cancer journey.

Obtaining a second opinion during your cancer treatment can be a daunting but also life-changing step; however, surprisingly few patients take this approach. Studies suggest that only about 6% to 36% of patients seek a second opinion, and yet patients who are advised about this option are more likely to do so.

Patients often assume that seeking another opinion may offend their oncologist. In reality, I and many other oncologists actively encourage our patients to do so. Oncologists who are offended or discourage their patients from seeking a second opinion may be putting their ego before their patient’s interests.

Why Do Patients Seek a Second Opinion?

Few studies have analyzed the factors that drive patients to obtain second opinions, or their impact on treatment. Available data suggest that patients are motivated not by any mistrust of their primary clinician but by a need to ensure that they have considered all available treatment options, to gain expert advice and to access clinical trial opportunities.

Should I Pursue a Second Opinion?

The benefits of obtaining a second opinion can be far-reaching. These can include improved outcomes, more manageable treatments and side effects, greater satisfaction with treatment, feeling empowered over your treatment and even an improved relationship with your primary clinician.

A second opinion can also enhance your experience if you don’t “click” with your initial oncologist. Given the complexities and stresses of the cancer journey, good rapport with and absolute trust in your oncologist are essential.

A Specialist Second Opinion Can Allow Access to Expertise in Rare Cancers

If you are able to see an oncologist in a specialist cancer center, a second opinion will give you access to the latest therapies, technologies, clinical trials and a different perspective on your treatment.

This is an approach that I particularly recommend if you have a rare cancer. A specialist center is more likely to give you access to an oncologist with experience in treating your tumor type, which can have a crucial impact on treatment outcomes.

What Factors Prevent Patients From Seeking a Second Opinion?

There are four principal barriers to obtaining a second opinion: a state of shock following diagnosis; worries over delaying the start of treatment, information overload and a fear of offending the primary clinician.

To address these challenges, I strongly recommend that clinicians communicate clearly, involve patients in all aspects of decision-making and ensure that patients feel empowered to participate in their care plans.

Are There Any Disadvantages to Seeking a Second Opinion?

There are potential disadvantages that patients should be aware of before seeking a second opinion. The involvement of a second clinician carries a risk of receiving inconsistent information about possible treatments and outcomes. It may also cause uncertainty and confusion for the patient in processing potentially contradictory information from two different sources. Some patients may feel that they have to work hard to liaise between oncologists in separate geographic locations. In a few cases, patients may seek a third or even a fourth opinion and may go along with whichever opinion they like the best, rather than the most appropriate one, which could compromise their outcome.

To counter these challenges, clinicians should work collaboratively to offer a coherent care plan. If you are seeking a second opinion, your clinicians may provide you with educational materials, which can help you navigate your way through information from different sources.

Can Technological Advances Assist Patients Seeking a Second Opinion?

Telemedicine is a useful resource that enables patients to engage virtually with consultants via video technology. The use of virtual second opinions has increased considerably in recent years. For patients with cancer seeking a second opinion, telemedicine can facilitate access to expert guidance and is particularly useful for those living in rural areas.

There has been much talk in recent months regarding the potential of artificial intelligence (AI) for diagnostic purposes in patients with cancer. However, the use of AI in the second-opinion setting raises ethical concerns regarding accuracy and the potential for under- and over-diagnosis. Therefore, at this time, I do not recommend AI to support oncology second opinions.

Patients Endorse Second Opinions For The Benefits That They Offer

Obtaining a second opinion is generally a positive step that many patients heartily endorse for its potential to enhance treatment outcomes, minimize side effects and offer greater peace of mind.

If you are at the beginning of your cancer journey, or you have questions or concerns about the treatment that you are receiving, consider seeking a second opinion to ensure that you receive the most effective and appropriate treatment for your situation.

Author affiliations: Creative Precision Oncology; Co-Founder of PrecisCa, an Online Virtual Second-Opinion Platform for Providers; Clinical Affiliate Professor, Department of Integrated Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University.

Contributing: medical writer Caroline Patrick

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