Consider Getting a Second Opinion
- Sarah Smith is a metastatic breast cancer survivor who just reached a five-year post-diagnosis milestone in May. She says her successful treatment is thanks to her husband and sister pushing her to get a second opinion.
- Metastatic, or stage four, breast cancer is technically not curable, but with ongoing advancements in treatments and options to dramatically reduce symptoms, there are many reasons to be hopeful.
- One of the greatest cancer researchers of our time tells SurvivorNet that people should get “multiple” opinions following a cancer diagnosis.
Smith was diagnosed with stage four, or metastatic, breast cancer in 2017. She was only 39 at the time.Read More
Understandably so, her mind went to the worst and she asked her doctor if the diagnosis meant she may on have six months to live.
“He said, ‘yes, it could be that fast,’” she said.
But, with a little encouragement, Smith sought out a second opinion.
“In the time between the first and second opinions, I had some time to kind of accept what was going on,” Smith told WXOW. “It wasn’t that initial shock right away. There was some time, but to come here, the way that Dr. Wisinski [her oncologist] described the cancer to us just made more sense – we had a great connection with her.”
And this second opinion, according to Smith, has made all the difference. Her initial treatment plan worked for three years before the cancer started resisting the therapies. That’s when Dr. Kari B. Wisinki, co-leader of the University of Wisconsin Carbone Cancer Center Breast Center Disease-Oriented team which organizes the clinical trials for breast cancer patients, looked into clinical trial options for Smith.
Clinical trials are research studies that compare the most effective known treatment for a specific type or stage of cancer with a new approach. They can give patients access to incredible new therapies, but they’re not for everyone and the treatments may very well not work for you.
Dr. Beth Karlan, a gynecologic oncologist with UCLA Health, previously told SurvivorNet that clinical trials can play an important role for some patients’ treatment, but they also serve a larger purpose.
“Clinical trials hopefully can benefit you, but it’s also providing very, very vital information to the whole scientific community about the effectiveness of these treatments,” Dr. Karlan said. “We need everyone to be partners with us if we’re ever going to truly cure cancer or prevent people from having to die from cancer.”
That being said, there is no guarantee you’ll receive more effective treatment than the standard of care, and clinical trials certainly aren’t right for everyone. You should always talk with your doctor(s) before getting involved in one.
Thankfully for Smith, the clinical trial she joined in 2020 seems to working for her, and her family was able to celebrate her reaching a five-year post-diagnosis milestone in May. The trial she’s partaking in gives participants the drug talazoparib in combination with a drug called gedatolisib.
“I think everyone should get a second opinion if you can,” Smith said. “It might be exactly what you need to find the right doctor and the right treatments for you.”
Understanding Metastatic Breast Cancer
Metastatic breast cancer – also called “stage four” breast cancer – means that the cancer has spread, or metastasized, beyond the breasts to other parts of the body. It most commonly spreads to the bones, liver and lungs, but it may also spread to the brain or other organs.
And while there is technically no cure for metastatic breast cancer, there is a wide variety of treatment options used to battle the disease including hormone therapy, chemotherapy, targeted drugs, immunotherapy and a combination of various treatments.
In a previous interview with SurvivorNet, Dr. Elizabeth Comen, an oncologist with Memorial Sloan Kettering Cancer Center, explained how she tries to manage breast cancer when it has progressed to a later stage.
“With advanced disease, the goal of treatment is to keep you as stable as possible, slow the tumor growth and improve your quality of life,” she said.
The American Cancer Society reports that there were more than 3.8 million U.S. women with a history of breast cancer alive at the start of 2019. Some of the women were cancer-free, and others still had evidence of the disease, but they also reported that more than 150,000 breast cancer survivors were living with metastatic disease, three-fourths of whom were originally diagnosed with stage I-III.
And with ongoing advancements in treatments and options out there today that can dramatically reduce symptoms, there are many reasons to be hopeful.
The Importance of Getting a Second Opinion
After receiving a cancer diagnosis, it’s important to remember that you can, and should, talk to other cancer specialists about your disease.
“If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care,” National Cancer Institute Chief of Surgery Steven Rosenberg told SurvivorNet in a previous interview. “Because finding a doctor who is up to the latest of information is important.”
As we highlight in several areas of SurvivorNet, highly respected doctors sometimes disagree on the right course of treatment, and advances in genetics and immunotherapy are creating new options. Also, in some instances the specific course of treatment is not clear cut. That’s even more reason why understanding the potential approaches to your disease is crucial.
At the National Cancer Institute, there is a patient referral service that will “guide patients to the right group depending on their disease state so that they can gain access to these new experimental treatments,” Rosenberg says.
Furthermore, getting another opinion may also help you avoid doctor biases. For example, some surgeons own radiation treatment centers.
“So there may be a conflict of interest if you present to a surgeon that is recommending radiation because there is some ownership of that type of facility,” Dr. Jim Hu, director of robotic surgery at Weill Cornell Medical Center, tells SurvivorNet.
Other reasons to get a second opinion include:
- To see a doctor who has more experience treating your type of cancer
- You have a rare type of cancer
- There are several ways to treat your cancer
- You feel like your doctor isn’t listening to you, or isn’t giving you good advice
- You have trouble understanding your doctor
- You don’t like the treatment your doctor is recommending, or you’re worried about its possible side effects
- Your insurance company wants you to get another medical opinion
- Your cancer isn’t improving on your current treatment
Bottom line, being proactive about your health could be a matter of life or death. Learn as much as you can from as many experts as you can, so that you know that you did your best to take control of your health.
Contributing: Marisa Sullivan