As a patient you have the right to a second opinion; Dr Lucienne van Schalkwyk talks us through how and when to go about getting one.
Receiving a breast cancer diagnosis is an overwhelming and life-altering event. And, because treatment plans have many physical, emotional and financial implications, it’s important to be completely comfortable with the treatment plan that you and your surgical oncologist decide to embark on. If you’re not completely satisfied or feel any unease, it may be a good idea to seek a second medical opinion.
Why seek a second opinion?
A study, from the United States, has revealed that the initial treatment plan is altered in up to 52% of patients seeking a second opinion from a specialist breast cancer team.
Many women wish to confirm their diagnosis; that their treatment plan is appropriate; or to gain more information about the different treatment options, such as mastectomy vs. lumpectomy, starting with surgery vs. starting with chemotherapy, and the management of the glands under the arm.
Often patients don’t like the way their specialist manages the decision making process; while some patients prefer an inclusive approach with shared decision making between doctor and patient. Other patients may prefer to follow the lead of their specialist but then may become frustrated when offered too many options without a clear direction.
Sometimes, the recommendation of the second specialist is the same as that of the initial doctor. This may reassure the patient and give them the peace of mind they need to proceed.
Where to go for a second opinion?
It’s important to get a second opinion from a doctor with adequate expertise in the field. If you’re unsure of where to seek a second opinion, your general practitioner may be able to assist with a recommendation, or alternatively you can do research on the internet or speak to breast cancer survivors at support groups.
Research shows that breast cancer is best managed in multi-disciplinary teams, which consist of several experienced specialists from different disciplines (such as surgery; medical- and radiation oncology; pathology and radiology) who arrive at a consensus on the treatment plan, after discussion in a meeting.
You have the right to a second opinion
There is no need to feel awkward or embarrassed when requesting a referral for an opinion from your current specialist. The Health Professions Act protects your right to a second opinion and states that no medical professional may impede a patient from seeking a second opinion.
Most doctors have no objection against their patients seeking a second opinion. If your doctor does react negatively, it may be time to re-evaluate whether he/she is the right fit for you.
Preparing for a second opinion appointment
If you have a medical aid, you’ll need to confirm whether a visit to a second specialist is covered. Remember to take all of your mammograms, ultrasound images and pathology reports along to your appointment, as the surgeon may request review of the radiology or pathology slides.
Prior to your appointment, write down all of the questions you would like to ask. Take a friend or relative along with you to help you listen to what the specialist has to say, and to help you to make notes of the answers to your questions, or if they allow record the conversation.
This process of open discussion and shared decision making should enable you to make informed decisions about your care and to embark on your treatment plan with confidence.
The Health Professions Act protects your right to a second opinion and states that no medical professional may impede a patient from seeking a second opinion.
MEET OUR EXPERT – Dr Lucienne van Schalkwyk
Dr Lucienne van Schalkwyk is a general surgeon with a special interest in breast surgery. Her practice manages the entire spectrum of benign and malignant breast disease, and her specific interests include breast conserving surgery and oncoplastic surgical techniques.