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Second opinions - are they helpful?

by Jerseygyrl on Fri Apr 25, 2014 8:54 am

Hi Everyone,

I'm curious how many of you have sought a second opinion regarding treatment options. Do you feel a second opinion is important, or do you feel it only adds to the confusion of making a decision on what treatment to choose?

Very interested in your responses :)

Thanks,
Kim

Jerseygyrl
Name: Kim
Who do you know with myeloma?: My Loved One
When were you/they diagnosed?: February 2014
Age at diagnosis: 58

Re: Second opinions - are they helpful?

by terryl1 on Fri Apr 25, 2014 10:31 am

Hi Jerseygyrl! I like your handle ... I am a Jersey guy from the southern part of the Garden State.

If your insurance allows it, why not get a second or third opinion from a myeloma specialist? Your doctor should understand that and should not feel slighted. It is a good thing to have different options and then you can make an informed decision for what is best for you.

Unlike many other medical conditions, there are different therapy options and different philosophies regarding treatment, as evidenced by this site. Also, some major cancer centers may have cutting edge clinical trials that may be worth looking into that your first doctor does not have.

Good luck.

Terry L.

terryl1
Name: Terry
Who do you know with myeloma?: self
When were you/they diagnosed?: August 10, 2011
Age at diagnosis: 49

Re: Second opinions - are they helpful?

by Multibilly on Fri Apr 25, 2014 12:09 pm

I'm totally with Terry on this. Best move I ever made was getting multiple opinions from docs with different philosophies on treatment. It was a real eye opener for me.

Even if insurance didn't cover it (mine does), I'd still pay out of pocket for the initial visit just to get a second take on things.

Multibilly
Name: Multibilly
Who do you know with myeloma?: Me
When were you/they diagnosed?: Smoldering, Nov, 2012

Re: Second opinions - are they helpful?

by goldmine848 on Fri Apr 25, 2014 12:48 pm

My view is that second opinions are very helpful. In my case, my treating doctor is very aggressive -- a strong proponent of early stem cell transplant. Although I was inclined to agree, my caregiver was more skeptical.

So we saw another myeloma specialist from the other end of the spectrum; she rarely recommends transplant. We had a very long discussion with her and, in the end, she conceded that she could not argue if we decided to go the transplant route. That discussion actually convinced both of us that transplant was the appropriate way to go.

After the transplant, my treating doctor recommended an aggressive maintenance regimen. I was inclined to follow a less aggressive approach, which I ran by the second opinion doctor. She agreed with my choice and that is the course that I am following.

goldmine848
Name: Andrew
When were you/they diagnosed?: June 2013
Age at diagnosis: 60

Re: Second opinions - are they helpful?

by NStewart on Mon Apr 28, 2014 11:42 am

I was diagnosed by a general hematologist/oncologist in another health system from the specialist that I am seeing now. Because I live in a city with 3 major health systems with cancer centers, I felt that I should get a second opinion from someone who treats only myeloma. Looking at the website of the first health system, I couldn't find a specialist even though I knew that they had them. So, I asked colleagues of mine who worked with the bone marrow transplant program where I am treated for recommendations for a myeloma specialist. The doctor who I am seeing is the one who was recommended by everyone.

In addition to having lots of possible choices nearby, I felt it was important to see a specialist since myeloma is a relatively rare cancer. The doctor who diagnosed me kept having to refer to a table of lab results and recommendations when he was talking to me about myeloma and possible treatment regimens. That didn't make me feel very secure in his ability to provide me with the cutting edge treatment as things progressed.

When I met my current oncologist he spent an hour with me reviewing all of my test results and what they meant. He talked with me about immediate treatment options and long term options. He also informed me of research that was ongoing and what trials were possibly coming in the future in the myeloma field. He gave me hope. I felt that I would be well cared for and stayed with him.

I do constantly re-evaluate my choice of doctors as my condition changes and/or remains the same. So far I have been happy with how my oncologist keeps me informed and lets me know his thoughts ahead of time about when he might change my treatment regimen.

Any time that you get 2nd and 3rd opinions from other specialists you are likely to get differences in treatment regimen opinions. It always comes down to what you feel is the right avenue to take for you. And, this may change as you continue with your myeloma journey. I may want to get another opinion in the future.

Nancy in Phila

NStewart
Name: Nancy Stewart
Who do you know with myeloma?: self
When were you/they diagnosed?: 3/08
Age at diagnosis: 60

Re: Second opinions - are they helpful?

by Christa's Mom on Mon Apr 28, 2014 12:43 pm

EJ and I did not go for a second opinion until he was getting ready for his SCT. Part of the reason was that we had too much going on personally to manage it, part of the reason was because we didn't really have a good understanding of what having multiple myeloma means. There never was a question about whether or not EJ had multiple myeloma, he was receiving excellent care, and all of our questions and concerns were being addressed by his care team so we didn't feel like we needed to get a second opinion at that time.

In the end, we did get a second opinion prior to his transplant when we started wondering if this was the correct thing to do. In the future, we plan on getting second opinions when we come to a crossroads in his treatment/disease.

Lyn

Christa's Mom
Name: Christa's Mom
Who do you know with myeloma?: Husband
When were you/they diagnosed?: September, 2010
Age at diagnosis: 53

Re: Second opinions - are they helpful?

by mrozdav on Sun Feb 01, 2015 6:02 pm

I find all of the comments on this thread most helpful. I am now at the point in my own treatment where I need to decide how to proceed in the future. Although I am being treated at Johns Hopkins, I have been thinking of late that perhaps my stem cell transplant should be done at the Mayo Clinic in Minnesota. In any event, because so many posters have written glowingly about their experiences at the Mayo Clinic, I am inclined to get a second opinion there about my entire situation, even if I ultimately do have a SCT at Johns Hopkins.

I just do not know how to go about seeking a second opinion and am seeking advice in this regard. How does one decide which doctor to see? What does one tell one's own doctor that a second opinion is being sought? (I think I feel needlessly awkward about doing this.) How does one get one's records transferred to the second opinion doctor? Will there be duplicate testing at the second center?

I will appreciate any responses.

mrozdav

Re: Second opinions - are they helpful?

by Multibilly on Sun Feb 01, 2015 7:03 pm

Q: How does one decide which doctor to see?

A: You can ask folks on this forum to respond to you via a private message as to which docs they prefer at a particular institution (out of respect for the medical community, folks on the Beacon generally try to avoid public comparisons of doctors).

Q: What does one tell one's own doctor that a second opinion is being sought? (I think I feel needlessly awkward about doing this.)

A: You shouldn't feel awkward about this. Docs are used to this and expect it, especially when cancer is involved. Just be up front with your doc. My local oncologist was not offended in the least when I said I was going to consult with a specialist out in California. In fact, my local doc got on the phone to the new doctor shortly after I got my second opinion from the new doctor, just to make sure that they were both on the same page. My local doc also confirmed that he would administer any drug treatments that my new doctor recommended, if that was my wish.

Q: How does one get one's records transferred to the second opinion doctor?

A: You can just contact your current doctor's front office and request that they send copies of your records to the new doctor. But I might also suggest getting paper copies of your original lab results, radiology reports, bone marrow biopsy (BMB) results, your doctor's diagnosis writeup, and CDs of any imaging that was done. Bring those items with you to your first visit. Even if you don't need them at your next appointment, I find it invaluable to have copies of all these records organized in one notebook, since I often refer to them.

Q: Will there be duplicate testing at the second center?

A: If you do a good job getting copies of all your tests and have all the records transferred well in advance of your second opinion appointment, chances are you won't need to have any additional testing done ... unless your current doctor is not ordering all of the tests listed in this link. Depending on the kind of imaging you've had done in the past, your new doc may request some new imaging (i.e. if you only had xrays done in the past, your new doc may recommend a PET/CT). The new doc may also request doing some additional tests for items that they may uniquely track what your current doc does not. As an example, I've had additional testing done for CRP, BCMA, etc when I've seen a couple of different specialists. Some specialists are also set up to do GEP testing, which is not commonly done at a lot of places, so you might be asked to get those tests done. I also had one specialist request the remaining sample from my bone marrow biopsy (labs apparently store this biopsy material for a period of time, which was a surprise to me), so that his pathologists could also examine it.

Multibilly
Name: Multibilly
Who do you know with myeloma?: Me
When were you/they diagnosed?: Smoldering, Nov, 2012

Re: Second opinions - are they helpful?

by mrozdav on Sun Feb 01, 2015 7:17 pm

Multibilly, Thank you so much.

mrozdav

Re: Second opinions - are they helpful?

by CabinGirl on Sun Feb 01, 2015 10:59 pm

I believe second opinions are very important. I obtained a second opinion from Mayo in Rochester, Minnesota. Both my regular oncologist and the Mayo myeloma specialist agreed on my diagnosis, and were in agreement on the treatment plan I did using Revlimid, Velcade, and dex for 4 cycles. They also both agreed that an early auto SCT was in my best interest (I am high risk due to del(17p) mutation from FISH test). So, for me, having my oncologist AND the Mayo specialist agree on everything was very comforting for me, knowing both docs were on the exact same page.

What really made me glad I obtained a second opinion from Mayo is that a radiologist in the Twin Cities who reviewed and read my PET scan said he did NOT detect any visible myeloma damage on my bones. However, the same PET scan images were sent to Mayo, where a doctor on the Mayo myeloma team reviewed the same images and detected four visible areas of bone damage.

So, for my own personal medical case, it was beneficial to get a second opinion.

CabinGirl
Who do you know with myeloma?: Self
When were you/they diagnosed?: Sept. 2014
Age at diagnosis: 57

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