The Power of a Second Opinion

Jim Grant is living proof that not every cancer diagnosis should be taken as the final word.

When doctors in Hopkinsville, Ky., told Jim he had lung cancer and needed immediate surgery, he and his wife, Brigitte, decided to get a second opinion at Vanderbilt-Ingram Cancer Center, one of only 39 National Cancer Institute-designated Comprehensive Cancer Centers.

Brigitte, whose first husband died of lung cancer, wondered if the newly diagnosed malignancy could be related to the bladder cancer Jim had been treated for a year earlier, but the local specialist assured her that it wasn’t.

The family physician helped get Jim an appointment at Vanderbilt-Ingram, but desperate to see a doctor sooner, Brigitte went online and filled out the self-referral form on the center’s Web site. Within hours, she was talking to a nurse with the Cancer Information Program.

Started in 1997, the toll-free telephone resource now has four nurses who field some 3,000 calls each year, says program director Teresa Knoop, R.N., who holds a master’s degree in nursing and has more than 20 years experience. People call to locate a doctor skilled in a specific procedure, arrange for a second opinion and, most often, to find out about innovative investigational treatments offered through clinical trials.

The nurses help patients work through insurance issues, pull together medical records and cross other hurdles, often logging dozens of phone calls and e-mails for a single caller. Knoop has found that people may not realize the difference a second opinion can make, while many older patients, especially, feel they will offend their hometown physician by asking about it.

“They don’t know to get a second opinion,” she says. “They don’t understand the importance of that, or they’re just absolutely scared.” But she knows from experience that the vast majority of oncologists and other physicians are very supportive when patients decide to ask another doctor to review their case. “Every day, I see it can make a difference,” she says.

As for Brigitte’s experience, she has high praise for the nurses and the assistance they offer patients and their family members.

“I think I called every day to see if there was a cancellation,” she says, mentioning nurse Pam Carney as a frequent contact. Her persistence paid off. Vanderbilt lung cancer specialist David Carbone, M.D., Ph.D., stayed late one day just after Thanksgiving to meet with the Grants and the second opinion process was set in motion.

Within a few days Carbone called with a message: “I’ve got good news. It’s bladder cancer, not lung cancer,” Brigitte recalls. A review of Jim’s case had revealed that the tumor in the lung was bladder
cancer that had spread, which meant the treatment would be different and the prognosis was much more promising. Jim began the first of four monthly treatments in December.

The 64-year-old health enthusiast has this advice for people faced with a cancer diagnosis: “I think if you’re at a community hospital where they’re not as specialized, you definitely need a second opinion.” While acknowledging that patients naturally might want to avoid the cost and time required to travel to a dedicated cancer center, Jim continues, “In the long run, it’s something you really need to do. It’s too serious a thing to take the easy way out.”

The tenacious Brigitte agrees: “Absolutely, go talk to another physician, a specialized oncologist in the particular field. The diagnosis could be the same, but you have the peace of mind of knowing that it is.”

– by Elizabeth Older