Quick Guide for a Second Opinion in Cancer Care
I would add just one point to this excellent advice from Dr. Tangella, CEO, DoveMed — your digital pathology images as well – these should be as portable as the rest of your medical records!
Written by : Krish Tangella MD MBA FCAP 
Krish Tangella MD MBA FCAP CEO, DoveMed Ltd
A diagnosis of cancer fills one with dread-whether being diagnosed for the first time or discovering recurrence after years of remission. Cancer can be emotionally stressful for a patient and his or her loved ones. The first reaction after a diagnosis is fear, followed by disbelief, denial, etc., which prompts one to seek a second or even third opinion. The recent trend of specialization(s) as a consequence of technological advancements has led many renowned institutions to specialize in the diagnosis and treatment of particular cancers. This has made second opinions more accessible for patients. Additionally, alternative treatment options are also becoming more available and visits from healthcare providers for such therapies are not unusual. In many cases, seeking care in a specialized center may not be necessary, because the initial cancer team may have provided the best treatment option.
However, if you have been diagnosed with cancer, there may be times when you need or want another medical expert’s opinion. When you make your decision to seek a second opinion, the following information will help you organize your medical records data, which can assist in treatment plans in the new institution. This list can also help you and the hospital of your stay avoid redundant tests, decrease wasteful expenses, and increase time efficiency. Have the following ready before seeking a second opinion:
- Records of medical history (hard copies) as well as notes from your primary care physician and other specialists
- If you’ve had surgeries, details of those with information on the surgeon who operated on you, his/her office address and notes
- Hospital records (if applicable), including a paper copy of your discharge summary
- If you underwent radiology examinations, such as X-rays, CT, MRI, ultrasound scans, and PET scan, please make a paper copy of the reports
- A DVD or USB copy of all of your radiology tests. Obtaining a copy of all the radiology procedures should not be difficult.
- If you’ve had biopsies, then a copy of pathology reports should be with you. The biopsies might have included punch biopsy, fine needle aspiration, bone marrow biopsies, tissue biopsy, etc. Some special tests might have been performed on the tissue biopsy that may include genetic profiling, molecular testing, cytogenetic testing, flow cytometric analysis, etc.
- If you have undergone radiation therapy previously, a copy of summary of radiation therapy, that includes the type of radiation used and the number of doses/cycles of radiation should be obtained. The notes of the radiation oncologist should preferably be obtained as well.
- If you have had chemotherapy, a list of all chemotherapy medications including number of doses, frequency and mode of administration (oral and intravenous) should be obtained.
- A record of immunotherapy, targeted therapy, etc. if performed, should be procured.
- Finally, please make a list of all physicians and therapists you’ve visited till date, with their contact information.
Important things to remember:
- Many institutions may charge a small fee for preparing the reports mentioned above. Please keep in mind that you might have to request your reports in writing. The health records department of the hospitals can also assist you in understanding the process of consolidating such healthcare information.
- You may also be required to pay higher out-of-pocket expenses if you seek care outside your current insurance network. Therefore, please contact the customer service of your insurance company before you seek care at another facility.
Seeking a second opinion, although it might not be needed, is your right, so that you feel comfortable and confidant in the decisions you make about your healthcare. Having an organized information package will help the new provider get all pertinent information from a single source (you) and facilitate smooth transition of your care from one cancer center to another.
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