Getting A Second Opinion

Before beginning any kind of cancer treatment, you want to be sure that the diagnosis is correct and accurate. Getting a second opinion may seem unnecessary and a waste of time, but consider this: Is it possible that this diagnosis could be wrong?

A pathologist is the only physician who can make the actual diagnosis of cancer. This individual is a medical doctor with specialty training in the examination and diagnosis of cells and tissues. These tissues are removed from the body by various types of biopsy procedures. The pathologist then examines them under the microscope to determine whether the tumor is benign or malignant.

It is a common misunderstanding that a definitive cancer diagnosis can be made on the basis of X-rays, mammograms, blood tests and physician examination. While these studies may cause a great concern that a cancerous (malignant) tumor is present, it is only when a pathologist studies a biopsy sample from a suspicious mass that a definite diagnosis of cancer can be made.

The reality is that mistakes are made in the diagnosis of cancer. Diagnostic accuracy depends on the individual pathologist’s training, experience and judgment. In fact, a number of scientific articles have confirmed that such errors occur in cancer diagnosis in an average of two to four percent of cases. Based on these percentages, it has been calculated that 30,000 incorrect cancer diagnoses occur annually in the United States.

Serious consequences of wrong diagnosis

These errors can lead to incorrect or inappropriate treatments that could cause serious medical consequences. In a review of biopsy slides, researchers from the Johns Hopkins Medical Institutions recently found that of 6,171 patients referred to the facility for cancer therapy, 86 patients were given significantly wrong diagnoses.

In 20 cases, patients received a second opinion that showed their lesions to be benign; five patients had growths at first judged to be benign and later found to be malignant, and another six had misclassified cancers. The findings were published in the December issue of the journal Cancer.

There is an easy solution to catch most of these mistakes, and that is to obtain a second opinion.

Your right to a second opinion

The American Cancer Society and the American Society of Clinical Pathologists recommend a second opinion for cancer diagnosis. The effort and expense necessary to obtain a consultation can be rewarded by the comfort of knowing that an original diagnosis was indeed correct.

To obtain the best medical care for you and your family, you should understand your patient rights. Those rights include:

  • You have the right to obtain a second opinion.
  • You have the right to select the pathologist who you want to review your microscopic (biopsy) slides.
  • With your signed release, the primary pathologist must send your pathology material to the second opinion consultant of your choice.
  • While it is courteous to advise your doctor, you do not need your doctor”s permission to obtain a second opinion. Do not let your doctor talk you out of getting a second opinion or of sending the slides to the expert of your choice. A confident doctor will support your desire to obtain a second opinion.

Author: By Barry M. Shmookler, MD, CEO of Academic Oncology Resources