Checklist
For a cancer second opinion, ask whether the diagnosis and stage are confirmed, whether the pathology will be reviewed again, which treatment options suit your cancer and why, whether a tumour board will discuss your case, and how treatment would be shared with your doctors at home. The US National Cancer Institute publishes similar questions for patients.
A second opinion asks a fresh specialist team to look at the same evidence. That evidence is mainly your pathology report, your scans and your treatment history. The National Cancer Institute explains that the pathology report gives the definitive diagnosis. It also notes that patients wanting a second opinion may need to request their slides or paraffin blocks from the hospital that took the biopsy. The questions below follow the order of a typical review: diagnosis first, then options, then practical planning.
Is the diagnosis confirmed?
- Do you agree with the type of cancer in my pathology report?
- Will your pathologists review my slides or blocks, and how should I send them?
- Are further biomarker or genetic tests needed on my tissue?
- What stage is my cancer, and has it spread?
- Do you need new scans, or are my recent images enough?
Which treatment options fit my case?
- Which treatments are available for my type and stage of cancer?
- What are the benefits and risks of each option for me?
- Which option would you recommend, and why?
- How soon does treatment need to start?
- Would a clinical trial be relevant for me?
How is the plan decided?
- Will my case be discussed at a multidisciplinary tumour board?
- Which specialists will be involved: surgeon, medical oncologist, radiation oncologist?
- How does your plan differ from the one I was given at home, and why?
- Can you put your opinion in a written report for my oncologist?
What would treatment in India involve?
- Would I need to stay in India for the whole course, or part of it?
- How many sessions or cycles are planned, and where are they given?
- Which side effects should I report straight away?
- Will treatment affect my ability to have children, and what can be done first?
- Should my attendant come to each appointment?
How will care continue at home?
- Can part of the treatment be given by my oncologist at home?
- Which medicines and supplements should I tell you about now?
- How will response to treatment be checked after I return?
- Who do I contact if I have a problem after going home?
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Ask early for slides and blocks
Requesting pathology slides or paraffin blocks can take time. Ask the hospital or laboratory that did your biopsy as soon as you decide to seek a second opinion, and check the receiving hospital’s instructions for sending them.
Questions people ask
Will a second opinion delay my treatment?
A review of existing reports can often be completed without delaying urgent treatment. Ask your current oncologist how soon treatment needs to start, and share that with the reviewing team. If timing is tight, say so when you send the case.
What if the second opinion disagrees with my first plan?
Ask both teams to explain their reasoning in writing. Differences may come from the pathology, the stage or newer test results. Share the second report with your current oncologist so the decision can be made with full information.
Can I get a second opinion without travelling?
Yes. A second opinion can be based on reports, images and slides sent in advance, followed by a teleconsultation. Travel is needed only if you choose to have treatment or further tests in India.
Sources
- National Cancer Institute: Questions to ask your doctor about your diagnosis
- National Cancer Institute: Questions to ask your doctor about treatment
- National Cancer Institute: Pathology reports
General information, not medical or legal advice. Rules change: confirm with the official source. How we write and check.