Second Opinions
Patients who receive a brain tumor diagnosis often want to get a second opinion. Getting a second opinion means asking another physician to review your case. A second opinion can confirm an initial diagnosis and/or can be used to compare suggested courses of treatment. If possible, it is best to get a second opinion before treatment has begun. A second opinion should be obtained as soon as possible to avoid delaying treatment.
What will my doctor think if I want a second opinion?
Some patients may find it difficult to seek a second opinion. Fear of offending their physician is the reason most frequently given for not obtaining a second opinion. Most physicians are not apt to feel offended if you seek a second opinion. Patients should understand that they have a right to a second opinion, and most health care professionals acknowledge that right.
A second opinion is a good idea if:
- Your physician is not a neuro-oncologist or does not have experience with brain tumors
- You want to confirm your primary physician’s recommendation or your doctor does not have a team of specialists to consult with
- You are interested in clinical trials
- You have difficulty communicating with your physician
- You have read about treatments that your physician is not familiar with
- You are unsure of the course of treatment your doctor is recommending
- You live in a rural area
- You have a rare brain tumor type
What does a second opinion involve?
Second opinions involve a review of pathology reports, laboratory tests, medical records and notes from the doctor who diagnosed your illness, and can include a physical examination. You may also be asked for insurance information. Ask the second-opinion physician to specify exactly what information must be provided to him or her in order to properly evaluate your case.
Some medical centers offer the services of a tumor board. A tumor board is a multidisciplinary group of health care providers involved in the treatment and diagnosis of central nervous system tumors. Neurosurgeons, neurologists, radiation oncologists, pathologists, and other medical professionals may be part of a tumor board. The tumor board meets and reviews the patient’s MRI films and clinical and pathological information, then discusses treatment options and makes a group recommendation regarding treatment.
What will I need to get a second opinion?
You will need copies of all scans, diagnostic tests, lab and pathology reports, and all records regarding your condition. As a rule, you should keep personal copies of these materials. Whenever scans are being made, request copies from the technician. This can lower the waiting time and cost that may occur if you request them at a later date.
What does a second opinion cost?
The cost of a second opinion can vary greatly. Most health insurance plans pay for second opinions. Exactly what your insurance company will cover depends on your particular plan. Check with your carrier before you have the second opinion to determine if you will have any out-of-pocket expenses. Ask the following questions beforehand:
- Does the doctor charge for a second opinion? If so, how much?
- Does your insurance company cover all or part of the cost? ·
- What will your out-of-pocket expenses be?
- If you have an HMO or PPO, will they pay for a second opinion from a doctor who is outside of their network?
- Can you seek a second opinion on your own? If not, whose authorization do you need?
- If you need your primary care doctor's consent to get a second opinion and she or he refuses, how can you appeal?
If you have to travel to another city for a second opinion, be aware that you may be responsible for those travel costs.
How can I help someone else seek a second opinion?
To act on another's behalf, you must have the patient's permission. Some medical professionals may require that you obtain the patient's permission in writing before they will cooperate with you. This is true even if you are a relative or friend.
How can I find a specialist?
Patients can ask their family physician for a referral to a specialist who can give a second opinion. Many major medical centers can provide a second opinion. Call them or visit their web sites to request information on how to proceed. Some treatment centers can even provide a second opinion via email. In addition:
- A person with a brain tumor can request a consultation with a team of specialists in the National Cancer Institute's Neuro-Oncology Branch of the Warren Grant Magnuson Clinical Center at the National Institutes of Health in Bethesda, Maryland at 301-402-6298.
- Patients may also call the National Brain Tumor Foundation to learn more about how to get a second opinion. NBTF can provide a list of treatment facilities around the country.
- The Cancer Information Service, at 1-800-4-CANCER (1-800-422-6237) can refer callers to treatment centers in their vicinity.
