Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The value of a cancer diagnosis second opinion

Wendy S. Harpham, MD
Conditions
September 8, 2009
Share
Tweet
Share

Here are words any patient awaiting cancer surgery would be thrilled to hear: “We are canceling your upcoming operation! It turns out that the suspicious changes we saw on your recent biopsy are completely benign.”

This happy turn of events happened in my life recently, thanks to a second opinion from a type of physician few patients realize plays a critical role in their care: the pathologist.

Pathologists are medical doctors who look through microscopes and use a variety of lab techniques to determine what disease(s), if any, are present in blood or tissue obtained with a biopsy. Their task is not as straightforward as putting a key in a lock and turning. (“Aha. The key turns, so this is cancer.”) Pathology is an art that depends on sleuthing skills and judgment calls.

When talking about cancer, some biopsies are straightforward because all the changes are obvious and typical for one specific type of cancer. Even a medical student could make the correct diagnosis. Other biopsies, like my most recent one, are difficult to interpret. In these cases, a second opinion from another pathologist helps both the patient and the patient’s physicians.

Considering how much rests on the pathology, it is surprising more patients and physicians don’t take the “second opinion” path at the time of diagnosis. After all, a wrong diagnosis leads physicians to prescribe the wrong therapy—garbage in, garbage out.

When the original diagnosis is confirmed by a second opinion, everyone feels confident they know what is wrong. This confidence makes it a bit easier to accept the risks of recommended treatment than if there were any uncertainty about the diagnosis.

When a second pathology opinion yields a different diagnosis, the stress level may rise in the short run. “Which opinion is right? What should I do now?” But with everyone working together to get the patient the best care, further discussion and, maybe, a third or fourth opinion eventually leads to the most likely diagnosis. Then, no matter what happens with the patient thereafter, everyone takes comfort in knowing they did the best they could.

Three reasons to think about getting a second opinion from another pathologist, preferably one who specializes in the disease that is suspected, are (1) if the biopsy tissue shows only subtle changes, (2) if the diagnosis is notoriously tricky and difficult to make, or (3) if the proposed treatment is especially risky.

It is important to discuss the patient’s medical condition and how much time is safe to take for additional pathology readings, so the added time does not compromise the patient’s chance for improvement.

Until sophisticated tests are developed that make pathology an exact science, a second opinion from a pathologist may play an important role in getting good care.

As a Healthy Survivor (namely, a survivor who gets good care and lives as fully as possible), I hope and pray for accurate news. And if the accurate news is also good news, that’s even better.

Wendy S. Harpham is an internal medicine physician who blogs at Dr. Wendy Harpham on Health Survivorship.

Submit a guest post and be heard.

ADVERTISEMENT

Prev

Do resident work-hour restrictions increase surgical complications?

September 8, 2009 Kevin 11
…
Next

Should patient satisfaction influence physician compensation?

September 9, 2009 Kevin 9
…

Tagged as: Oncology/Hematology

Post navigation

< Previous Post
Do resident work-hour restrictions increase surgical complications?
Next Post >
Should patient satisfaction influence physician compensation?

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Wendy S. Harpham, MD

  • Alternative cancer therapies and the promise of false hope

    Wendy S. Harpham, MD
  • What cancer taught this physician about hope

    Wendy S. Harpham, MD
  • a desk with keyboard and ipad with the kevinmd logo

    It takes time to deliver efficient care

    Wendy S. Harpham, MD

More in Conditions

  • How medical culture hides burnout in plain sight

    Marco Benítez
  • Financing cancer or fighting it: the real cost of tobacco

    Dr. Bhavin P. Vadodariya
  • 5 cancer myths that could delay your diagnosis or treatment

    Joseph Alvarnas, MD
  • When bleeding disorders meet IVF: Navigating von Willebrand disease in fertility treatment

    Oluyemisi Famuyiwa, MD
  • What one diagnosis can change: the movement to make dining safer

    Lianne Mandelbaum, PT
  • How kindness in disguise is holding women back in academic medicine

    Sylk Sotto, EdD, MPS, MBA
  • Most Popular

  • Past Week

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Physician patriots: the forgotten founders who lit the torch of liberty

      Muhamad Aly Rifai, MD | Physician
    • The hidden cost of becoming a doctor: a South Asian perspective

      Momeina Aslam | Education
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
    • Why fixing health care’s data quality is crucial for AI success [PODCAST]

      Jay Anders, MD | Podcast
    • How the 10th Apple Effect is stealing your joy in medicine

      Neil Baum, MD | Physician
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • How the 10th Apple Effect is stealing your joy in medicine

      Neil Baum, MD | Physician
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
    • How functional precision oncology is revolutionizing cancer treatment [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • When a doctor becomes the narrator of a patient’s final chapter

      Ryan McCarthy, MD | Physician
    • Why innovation in health care starts with bold thinking

      Miguel Villagra, MD | Tech

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 6 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Physician patriots: the forgotten founders who lit the torch of liberty

      Muhamad Aly Rifai, MD | Physician
    • The hidden cost of becoming a doctor: a South Asian perspective

      Momeina Aslam | Education
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
    • Why fixing health care’s data quality is crucial for AI success [PODCAST]

      Jay Anders, MD | Podcast
    • How the 10th Apple Effect is stealing your joy in medicine

      Neil Baum, MD | Physician
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • How the 10th Apple Effect is stealing your joy in medicine

      Neil Baum, MD | Physician
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
    • How functional precision oncology is revolutionizing cancer treatment [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • When a doctor becomes the narrator of a patient’s final chapter

      Ryan McCarthy, MD | Physician
    • Why innovation in health care starts with bold thinking

      Miguel Villagra, MD | Tech

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The value of a cancer diagnosis second opinion
6 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...