Second opinions

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Lordylordy
Posts: 13
Joined: Fri Feb 14, 2014 3:06 pm

Second opinions

Postby Lordylordy » Tue Feb 03, 2015 4:45 pm

Everyone here seems very set on getting second opinions. It makes a lot of sense. But, what if you doctor is Dr. Kemeny, do you still get another opinion and from who??

Thanks!

KWT
Posts: 3214
Joined: Thu Jul 11, 2013 7:22 pm

Re: Second opinions

Postby KWT » Tue Feb 03, 2015 5:04 pm

Unless she says something you don't like it sounds like you're good to go.

Nik Colon

Re: Second opinions

Postby Nik Colon » Wed Feb 04, 2015 3:13 am

I didnt get any second opinions on who I seen. I was told they were some of the best. CR surgeon did his own sig after my colonoscopy. Had ct and pet scan, both checked by 2 or more docs and compared, etc. I have had an overall great experiences with everyone I have seen so I'm sticking to the plan as of now. I guess it would be up to you and where you live, who specialize in it, etc, then make the decision you feel is the right one for you.

rp1954
Posts: 1540
Joined: Mon Jun 13, 2011 1:13 am

Re: Second opinions

Postby rp1954 » Wed Feb 04, 2015 4:08 am

Opinions are also part of our learning process. In more advanced circumstances, Kemeny or MSKCC might demur from multiple site met surgeries that another group would still be willing to tackle multimodally. A consult with Dr Lin for other chemo options down the road might be useful. Different kinds of doctors have different opportunities. Extra preparation with more options/drs on tap, not being technically and psychologically dependent on one view, is an important defense against the unexpected.
watchful, active researcher and caregiver for stage IVb/c CC. surgeries 4/10 sigmoid etc & 5/11 para-aortic LN cluster; 8 yrs immuno-Chemo for mCRC; now no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher, peaking ~2011-12, taper to almost nothing mid 2018, mostly IV C

Carolinabluetec
Posts: 415
Joined: Wed May 28, 2014 11:52 am
Location: Greenville, SC

Re: Second opinions

Postby Carolinabluetec » Wed Feb 04, 2015 7:55 am

I suspect that it depends somewhat upon the how you are staged. I suspect that that very few Stage I or Stage II people seek second opinions unless the original Doc suggests something totally off the wall or is a PIA.
03/14 DX Adenocarcinoma Sigmoid Polyp
05/14 Da Vinci Sigmoid Colectomy
06/14 T3N0Mx, staged IIa
07/14 Xeloda 3000 mg/day 14 on/7 off 8 rounds
12/14 Finished Chemo
01/15 CT NED :D
07/15 Colonoscopy NED :D
08/15 CT NED :D
03/16 CT NED 8)

jjinmd
Posts: 88
Joined: Thu Dec 18, 2014 9:24 am

Re: Second opinions

Postby jjinmd » Wed Feb 04, 2015 10:25 am

I haven't gotten any second opinions (yet). As others have said, I was comfortable with what I was hearing vs. what I had researched, and felt like the experience level of my docs was totally up to par with my diagnosis. If that changes down the line, I would seek a second opinion from a specialist in whatever comes my way. Sounds like you are in good hands!
42 year old Mom of two
7/14 Stage IV rectal cancer; CEA 70
4 rounds FOLFIRI/Avastin; 5 days radiation
11/14 TME, Liver resection, Temp Ileo - cPR
6 rounds FOLFOX
4/15 CT = NED
5/15 Ileo reversal
7/15 CEA = 2.1

alphagam
Posts: 203
Joined: Tue Jun 14, 2011 10:48 am
Facebook Username: Kathy Maine Ruess

Re: Second opinions

Postby alphagam » Wed Feb 04, 2015 10:38 am

My first thought, almost, was getting a second opinion. My gut feeling was well founded as the first GI told me I had a T3 tumor based on EUS, that I need chemo/rad, rest, APR and follow-up chemo. 2nd opinion found a localized 5 cm mass that was only in the lining of the rectum. Stage 0. Follow ups continue, next scope is 3 March, but I will ever be thankful for my 2 NED opinion
Dx Feb 2010 4 cm tumor, just inside rectum
EUS stated T3 tumor
2nd opinion, need better path
Mar 2010 transanal surgery. Surgery by board certified CRS found tumor only in lining
6 exams of surg site, 3 PET, 3 scopes laterNED.
Scope in Mar2015, clean colon
Next scope/test in 3 years

lentini66
Posts: 11
Joined: Wed Mar 19, 2014 9:13 am
Location: Denver, CO

Re: Second opinions

Postby lentini66 » Wed Feb 04, 2015 11:40 am

I saw Dr. Kemeny at SK for a 2nd opinion at the urging of people in my family. By the time I saw her I already had the Stage 3c tumor removed and wanted to be sure that the chemo treatment that I was set to start in Denver, CO was what she would do. She explained that there are some very standard treatment protocols and that the Folfox, that was recommended was the standard and that she wouldn't do anything differently.
Andrew
Dec. '12 StageIIIc diagnosed
Dec. '12 colon resection-colostomy
Jan.'13 Folfox x12
July 13 Chemo ended
Sept 13 Colostomy takedown-Protective Ileostomy
Nov 13 Ileostomy reversal
Since then, 4 CT scans, NED

nkoske
Posts: 442
Joined: Fri Feb 22, 2013 2:00 pm
Location: California

Re: Second opinions

Postby nkoske » Wed Feb 04, 2015 11:46 am

Lordylordy wrote:Everyone here seems very set on getting second opinions. It makes a lot of sense. But, what if you doctor is Dr. Kemeny, do you still get another opinion and from who??

Thanks!


The ultimate second opinion
It might have been nothing, but Scott had gotten her thyroid removed a few months earlier, so the pair had been keeping an especially close eye on anything that might have indicated a complication. Balzer pestered his wife to get an MRI, and when she finally agreed, the scan revealed a mass inside her skull, a three-centimeter tumor lodged behind her left eye. They were understandably terrified, but neurologists who read the radiology report seemed unconcerned, explaining that such masses were common among women, and suggested Scott have it checked again in a year.

That didn’t sit well with Balzer. Scott’s recent thyroid surgery had taught them that getting the best care requires being proactive and extremely well informed. A typical thyroid removal is performed via a large incision across the throat that requires a long, uncomfortable recovery and leaves a big scar, but when he and Scott began looking for alternatives, they discovered that she could avoid all that if they traveled from their home in California to the Center for Robotic Head and Neck Surgery at the University of Pittsburgh Medical Center. There, surgeons perform delicate procedures with a robotic arm that scales down their movements, making them smaller and more precise than what the human hand is capable of alone. The experience familiarized Balzer and Scott with both the cutting edge of medical technology and the importance of doing their own research. So although the first doctors told them to wait, Balzer and Scott sent the MRI results to a handful of neurologists around the country. Nearly all of them agreed that Scott needed surgery.
...
Balzer downloaded a free software program called InVesalius, developed by a research center in Brazil to convert MRI and CT scan data to 3D images. He used it to create a 3D volume rendering from Scott’s DICOM images, which allowed him to look at the tumor from any angle. Then he uploaded the files to Sketchfab and shared them with neurosurgeons around the country in the hope of finding one who was willing to try a new type of procedure. Perhaps unsurprisingly, he found the doctor he was looking for at UPMC, where Scott had her thyroid removed. A neurosurgeon there agreed to consider a minimally invasive operation in which he would access the tumor through Scott’s left eyelid and remove it using a micro drill. Balzer had adapted the volume renderings for 3D printing and produced a few full-size models of the front section of Scott’s skull on his MakerBot. To help the surgeon vet his micro drilling idea and plan the procedure, Balzer packed up one of the models and shipped it off to Pittsburgh.
...
Scott had the tumor removed at UPMC in May 2014 through a small opening above her left eye. The neurosurgeon discovered that the tumor was starting to entangle her optic nerves, and told her that if she had waited six months, she would have had severe, and possibly permanent, degradation of her sight. The procedure took eight hours and 95% of the tumor was removed. She was back at work in three weeks. Her scars, Balzer says, are visible only to her.


http://makezine.com/magazine/hands-on-health-care/


Especially when it comes to surgery a lot of times what one docs thinks may not be possible another may attempt.
Nick, DX @ age 34, IIIB Rectal Cancer 10/2012
ChemoRad IMRT 11/2012
Laparoscopic LAR 1/2013 (No Ileo)
Post Surgery Path IIIB (2/15 LN)
Chemo 2/2013 (XelOx)
Currently NED, Graduated from Med Onc 10/2017

lpas
Posts: 1010
Joined: Wed Nov 19, 2014 11:11 pm

Re: Second opinions

Postby lpas » Wed Feb 04, 2015 12:23 pm

lentini66 wrote:I saw Dr. Kemeny at SK for a 2nd opinion at the urging of people in my family. By the time I saw her I already had the Stage 3c tumor removed and wanted to be sure that the chemo treatment that I was set to start in Denver, CO was what she would do. She explained that there are some very standard treatment protocols and that the Folfox, that was recommended was the standard and that she wouldn't do anything differently.


I saw Dr. Marshall in DC for a 2nd opinion several weeks ago and he essentially told me the same thing. Seems like there's not a lot of room for creativity when it comes to chemo regimens at Stage III, although I'm tentatively planning to try Celebrex as an add-on to the standard FOLFOX/XELOX.
11/14 Dx sigmoid CC @ 45yo
12/14 Colectomy + hysterectomy
Stage IIIB, T3N1bM0, 2/20 nodes, MSS, G2, KRAS(A146T), TP53, SMAD4, ERBB2, CEA 1.0
2/15-7/15 XELOX & celecoxib
2/19 clean scope
11/19 clean CT
Ongoing cimetidine & other targeted supplements
Mom to a 6 & 8yo

User avatar
exaussie
Posts: 618
Joined: Sun Jan 19, 2014 1:19 am
Location: Silverton OR
Contact:

Re: Second opinions

Postby exaussie » Wed Feb 04, 2015 1:05 pm

I think it depends on how you feel and if you are comfortable with Drs advice and also staging and age. We had 2nd and 3rd opinions as our son was stage 4 and 27 yrs old. By the way, we were told the same diagnoses and chemo regimen from all 3 Drs so we were good to go.
DS 26 yrs old diagnosed 6/13 T3N2aM1b
Resection 6/13
6 rounds chemo folfax
12/13 Fissure
hernia surgery 12/13
5 months break
Maintenance chemo 3/14
Crazy growth. Liver failing. Folfox and vectibex 7-29-14
Chemo failure Hospice 8/26
Left us 8/28

Nik Colon

Re: Second opinions

Postby Nik Colon » Wed Feb 04, 2015 3:45 pm

I would like to add my 2 cents once more. It's great if you have the time, money, etc to look all over but many dont. I live in MN and I feel comfortable with almost anywhere I go as I know MN has some of the best docs in all fields. I am going to the U of M which I know the Mayo clinic is #3 in cancer, #1 in many others and in the top in like 16 specialties. We have other of the best treatment centers, etc. I know U of M is not #1 but they are still good and closer. I can't afford THE BEST IN THE WORLD, so I will take pretty Fricken good!


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