At the Medical University of South Carolina’s Hollings Cancer Center, a group of medical specialists gather around a meeting room table on a Tuesday morning. They all come from different medical backgrounds: oncology, genetic counseling, radiology and nursing, among others.
Led by Dr. Nancy DeMore, medical director of the hospital’s breast program, they are examining the data of patients recently diagnosed with breast cancer. The purpose is to provide these patients with a second opinion on their diagnosis and potential course of treatment.
“If you’re not (a patient) in a specialized cancer center, seeking out a … second opinion could be a good idea,” Dr. DeMore said.
In a recent study conducted by MUSC researchers, Dr. DeMore and her colleagues discovered that of 70 breast cancer patients who reached out to her team for a second opinion, almost half had a change in diagnosis.
More than 20 percent of those patients had additional cancers diagnosed.
For breast cancer patients, a change in diagnosis can mean the difference between a lumpectomy (breast-conserving surgery) and a mastectomy (breast removal surgery).
“I think most physicians are very appreciative of having a second look," Dr. DeMore said.
While the new research doesn’t necessarily translate to other diseases or even other hospitals, it does highlight the potential value of seeking a second medical opinion.
Even so, requesting one can be intimidating. Some patients might feel like it’s an insult to their doctor to suggest it. But MUSC officials said most doctors welcome and encourage second opinions.
“That’s a stigma that will hopefully fade over time because it’s your health,” said Dr. Denise Garcia, who wrote the study on second opinions and is completing a general surgery residency at MUSC. “If you don’t feel bad trying on a couple of different pairs of shoes or checking out a different car dealer, why wouldn’t you have the same level of certainty and curiosity about what else is out there with your own health, which is even more important.”
DeMore and her team theorized that the results of the recent research may be unique to South Carolina. Patients who seek a second opinion at MUSC’s Hollings Cancer Center may be traveling from rural parts of the state where specialized health care experts are scarce. Breast cancer is an illness with constantly changing treatment and diagnosis methods. And there is a concentration of expertise at MUSC, she explained, that conducts new research and stays informed about the latest breakthroughs.
“It’s also being part of the process of contributing to new knowledge,” she said.
Meanwhile, other studies on the value of second opinions are less clear. While many cancer patients often seek a second opinion for a variety of reasons, including “lack of trust” and a “need for more (personalized) information,” a review of 25 studies published in the medical journal Oncology last year found disagreements between first and second medical opinions ranged widely, from 2 percent to 51 percent. “Additional research should evaluate how unnecessary second opinions might be avoided,” the authors wrote.
Dr. Todd Williams, an oncologist with the Trident Cancer Center, said in his experience a cancer diagnosis typically doesn't change with a second opinion. However, he said that shouldn't affect a patient's decision to seek one out. Sometimes, seeking a second opinion allows patients to ask more questions and get additional comfort and reassurance.
"If you have any questions, please get as many second opinions as you need to feel comfortable," Williams said. "It never hurts."
But the price tag may be higher. Patients seeking a second opinion from a doctor outside their health insurance network will almost certainly encounter additional health care costs.