Deciphering second opinions
Last week, someone who has relapsed after four years called to ask what I thought she should do after getting a second opinion which disagreed with the first. This is always a dilemma. Does it mean that the first doctor is wrong? Or is it the second one? Most probably, they were both right.
In one sense, those of us who have NHL are "lucky" that there is an array of treatment options. In another sense, it's hard to know which one is the "right" one. Treating the disease is as much an art as it is a science, and two different doctors can have differing opinions and both can still be right.
If this happened to me, I would look at the credentials of both doctors and ask the following:
1. Who has treated the most NHL cases?
2. Is one a hematologist/oncologist, i.e., a doctor who specializes in cancers of the blood?
3. Has one or the other recommended a clinical trial?
4. Have they both included the latest treatments, such as radioimmunotherapy, as options? If not, why not?
5. Why is he or she is recommending one particular treatment over others?
6. Which treatment offers the best outcome, based on scientific evidence?
7. How does each treatment fit into my personal goals?
As new treatments are approved and make their way from research facilities into mainstream medicine, they sometimes take awhile to gain strong, solid footholds simply because it takes time to educate doctors about how and when to use them. In the case of radioimmunotherapy, it has been FDA approved for about four years, and it should, by now, be regularly mentioned to patients who might benefit from it. If you think you may be a candidate for it and your doctor doesn't offer it as an option, I would ask about it.
When two or more doctors recommend different treatments, it can be very disconcerting, but it doesn't necessarily mean that one is right and the other wrong. It usually means there is more than one way to attack the disease, and when faced with multiple options, you will have to keep probing for answers to find your own level of comfort. Ask, ask, ask......until you are satisfied.
Betsy