My name is David Plume, I'm a GP in Norfolk and I'm Macmillan's Lead GP for cancer
and end of life for East Anglia.
A second opinion is, as the name suggests, simply a second opinion from another doctor.
People often want a second opinion at the point of diagnosis because
it's a horribly traumatic experience, they are worried that someone's made a mistake
that they haven't actually got cancer but invariably, most second opinions are taken
at a point when it's talking about treatment
rather than about whether the cancer diagnosis exists or not.
Some people will have had tests and investigations and will have nervously waited around for the results
only to be told that they don't have cancer and they may still feel very unwell.
I would suggest to these people that they go back and see their GP
who can then look again at their signs and symptoms and look at whether there are other
diagnoses that may have been overlooked
in a rush to get them up and a diagnosis of cancer excluded.
They are three ways you can go about getting a second opinion.
The first of which is to go back and see your GP
and your GP can talk you through what's happened on your treatment plan
look at the issues that you might have with that treatment plan
and then arrange with you, a referral on to another oncologist,
if that was felt by both of you to be appropriate.
The second option is to speak to your oncologist.
If you feel your treatment plan doesn't fit with what you expected talk to your oncologist
they're not scared, you're not going to insult them, you're not going to upset them
and they would much rather you were honest with them
and explained what your thought processes were and why you were worried,
and then if necessary then can ask a colleague oncologist to see you
to reassure you, if appropriate.
The third option, and the slightly more difficult option, is to do your own research
and to look at other regional treatment centres where you might want to get a second opinion
and in this case it's often helpful to approach the hospital directly
who may then require an oncologist-to-oncologist transfer of notes and information in order
to accept the referral.
There's no need to be worried if you want to get a second opinion
no one's going to think any less of you, it's not going to influence or impact on your care
and the hospital are more than happy to talk you through the process often, and help you
and support you to make sure the right information
goes to the right people to allow this to happen.
Ultimately what people want is for you to be comfortable and happy with the plan
and if there are ways they can facilitate that they will help you.
People worry that having a second opinion is going to be a difficult or traumatic process
that the hospital you're being referred from or the hospital you're being referred to
will be difficult or obstructive in some way.
Actually, the hospital wants you to be comfortable with what's going on
and both the hospital that's referring you and the hospital to which you're being referred
are going to be helpful and accommodating, will be able to support you in this process.
Ultimately what everybody wants is for you to be comfortable and happy with your treatment plan
and for you to get the treatment that you want and that is clinically appropriate for you.
So they'll do everything they can to facilitate that for you.
One of the big downsides to getting a second opinion is time.
We refer people up to the hospital under the 'two-week wait'
so they're seen very quickly because we know that early diagnosis is really important
but what's also important is getting early treatment.
If you're spending time getting a second opinion, seeing people,
maybe having other tests and investigations that's time that you're not having treatment
and that may therefore have an impact on your prognosis.
By the time you see someone, and further assessments are made things may have moved on
you may find that treatment options are less than they were before.
Alternatively, you may just be told the same information you were told in the first instance
and unfortunately, you've then spent a wasted period of time
that could have been spent on treatment.
There are upsides to getting a second opinion
and you may be given better news when you have your second opinion
it may be that the disease is more treatable than was originally thought
it may be that there are other treatment options that your other oncologist or previous oncologist
was not able to offer you
and obviously that may be beneficial for you, for your family and those people that you love.
I think if you're thinking about getting a second opinion,
we've talked about the three different ways of doing it
but if you are thinking about getting a second opinion I would suggest going to see your GP.
You need to be very clear in your own mind about what you're trying to achieve
by getting a second opinion.
If you talk to your GP and use your GP as a sounding board for your thoughts and concerns
and ideas, your GP should be able to give you some balanced opinion and idea
about whether getting a second opinion would be useful or not.
For information, help, or if you just want to chat
call the Macmillan support line on 0808 808 00 00
or visit macmillan.org.uk