SHOULD YOU GET A SECOND OPINION?
YOUR chances of getting an effective second opinion through the NHS before you start treatment are nowadays negligible. The capacity just isn’t in the system.
The only way is to get a private appointment. This will cost between £250 and £350. It may be worth doing just to give you and your family peace of mind.
You could persuade someone to give it you as an early birthday present.
Make sure you’ve got all your clinical data — the imaging and biopsy reports, together with the proposed NHS treatment plan.
As for who you should see for a second opinion, there’s no point asking the consultant that’s going to treat you. They are likely to refer you to one of their chums.
There are patients who have the money to go to one of the big U.S. cancer hospitals such as Memorial in New York or MD Anderson in Houston for a second opinion, but it’s prohibitively expensive — it will set you back £100,000 or so plus travel and hotel costs.
But there’s no real need to leave your home country, because news travels fast in oncology.
It’s vital you see someone who specialises in your type of cancer and is bang up to date. Not too young and not too old. The ideal age is 45 to 60 years.
They should be taking part in clinical trials, work in a large cancer centre and publishing academic literature.
Most such consultants do private work. Doctors are not allowed to advertise their services directly but if you look on the websites of large private hospitals and clinics you will very likely find them listed there. Try these websites by searching for your type of cancer.
The other way is to ask around, but I can’t stress enough how important it is that the expert you choose specialises in your type of cancer.
Once you’ve identified who you think could give a good opinion, check out their publications over the past five years on Google Scholar. Put in their full name and see how productive they’ve been in areas associated with your cancer type. One further trick: some older doctors may not see you without a referral letter — but this may be difficult to obtain.
Get an appointment and say you’ll sort out the letter. You can ask your GP just for the letter or you can ask the consultant who first saw you. In truth, if you’ve got all your clinical information on hand, then the referral letter is not important. The whole charade is a throwback to a different age of medicine when the system held all the cards, and you were just an ignorant nuisance. Times have changed.
Make sure that the doctor you’re consulting for a second opinion has as much clinical information as possible sent to them in advance of the appointment. Take along your partner or a close friend and, if you like, ask if they mind you recording their recommendation on your phone. Good doctors won’t mind.
People often ask me whether a second opinion is really worthwhile. In my experience, the initial diagnosis is very rarely wrong. In less than 5 per cent of cases will the assessment be radically changed.