Ask the Oncologist (#1): Second Opinions

Should I Consider a Second Opinion After a Cancer Diagnosis?

This question comes from subscriber

Tom Chin

, from Bothell, Washington.

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What are the benefits and drawbacks of getting a second opinion after a cancer diagnosis? For a cancer patient seeking a second opinion, how long after the cancer diagnosis should the second opinion appointment take place? What are some other important, practical details about second opinions?

If you’re asking the question, “Should I get a second opinion?” the answer is almost always yes.

Second opinions don’t always change the treatment plan. But they often change how people feel about the plan, which can make a real difference. As an oncologist, I’ve seen second opinions bring clarity, reassurance, and sometimes even new options. You don’t need a special reason to ask. Wanting to better understand your choices is reason enough.

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When Second Opinions Are Especially Helpful

• The diagnosis needs confirmation
  Some centers will have a second pathologist review your biopsy and occasionally that’s a subspecialist with deeper experience in your specific cancer type. That extra layer of review can make sure your diagnosis is accurate from the start. Radiologists may also take a second look at your imaging to confirm staging or catch subtle findings that could shift your plan.

• The cancer is rare or complicated
  Not every oncologist has training or experience in every kind of cancer. If you’ve been diagnosed with something less common like sarcoma, a rare lymphoma, or a tumor in an unusual location it may be worth seeing someone who focuses exclusively on that disease.

• There’s more than one path you could take
  Some cancers fall into gray areas, where guidelines offer multiple reasonable options. Take low or intermediate-grade prostate cancer, for example. One doctor may recommend active surveillance, while another leans toward treatment. In these cases, a second opinion can help clarify what fits best with your goals and values.

• You’re exploring clinical trials
  Not all trials are widely advertised or available everywhere. A second opinion can reveal new possibilities, especially if you’re being treated in a smaller hospital or community setting.

• Something just feels off
  Maybe the plan feels rushed. Maybe your questions aren’t being answered. Or maybe your gut is telling you to pause. That’s enough of a reason. Good doctors understand and support the decision to get another perspective. You need someone who listens, who explains things clearly, and who makes you feel like you’re part of the process. Trust and communication are a big part of good cancer care. If something feels off emotionally, it’s okay to look elsewhere.

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You’re not being disloyal

I hear this more than you would think. Some patients feel like getting another opinion is “cheating” on their doctor. It’s not. It’s your life, and good doctors support the idea of getting more information. If your oncologist doesn’t, that’s a red flag.

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Potential Drawbacks to Consider

• It might delay the start of treatment by a few days or weeks.

• It could involve some travel or out-of-pocket cost.

• You may get different recommendations, which can feel confusing at first. But to me, that’s usually a sign that more conversation is needed. It’s a chance to step back, ask better questions, and get clarity from your team before moving forward.

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Timing and Practical Tips

Ideally, a second opinion should happen within a week or two of diagnosis and before treatment begins. But it’s rarely too late. I’ve had patients seek second opinions mid-treatment or even after treatment ends, just to confirm the plan or talk through next steps.

If you're planning to get one, here are a few tips:

• Bring your records and/or ask your care team to send them ahead, include molecular profiling reports as might not be in the EMR.

• Check your insurance to see if a referral is needed.

• Ask your oncologist for help finding the right person to see. Do not be afraid to ask around. Nurses and other healthcare workers often know who the best doctors are.

• Consider looking into an NCI-designated cancer center within driving range if possible. They often have sub-specialists in multiple types of cancer.

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You only get one chance to start treatment with full confidence. If something feels off or if your instincts are nudging you, listen. You deserve to feel informed. You deserve care that reflects your values and your life.

Here’s a thoughtful article by Dr. Robin Zon, President of ASCO, that speaks to this beautifully. It also highlights a second opinion program here in my hometown of Cincinnati:

Great Care Begins with a Great Plan – Dr. William Barrett and Sherry Hughes

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This is the first post in a new weekly series called Ask the Oncologist.
Each week, I’ll answer real questions I get from patients, caregivers, or readers about treatment, prevention, clinical trials, managing side effects, and more.

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