April 17, 2007
The Advertiser

Cancer Control: Second Opinions Remain Important in Cancer Diagnosis

By Becca Begnaud

QUESTION: I had symptoms of breast cancer, such as an inverted nipple. My surgeon, recommended by my physician, relied on mammograms and all of them were negative. How long should one wait before seeking a second opinion? I had faith in my doctor and didn't want to antagonize him by getting a second opinion, but I felt something was not right. After three years, a biopsy was performed and I was diagnosed with Paget's Disease, a type of breast cancer. I had a modified radical mastectomy and six months of chemotherapy.

PHYSICIAN'S ANSWER: The sooner you get a second opinion, the better. In this case, an MRI of the breast could be recommended to provide the maximum information for a quick decision leading to an early diagnosis and treatment. It certainly is within our rights to seek a second opinion and a second opinion always should be welcome.

Every individual has their own level of comfort, and if what you feel or have been told is questionable, a second opinion certainly is in order. Second opinions can be beneficial to both the patient and the doctor in getting good results for the patient and helping to insure a prompt diagnosis and appropriate treatment. The second opinion should be a reputable one.

Time is of the essence in many instances. I welcome second opinions in my practice so that I can work to the satisfaction of the patient providing good results for decisions regarding diagnosis and treatment. Currently, in a patient displaying abnormal physical findings, as in this case when mammograms are negative but the physical signs remain, an MRI would be beneficial. It is an adjunct diagnostic procedure to the mammogram and ultrasound in the diagnostic process. Avoidance of unnecessary biopsies also is important.

- Dr. Luis Meza, Oncologist/Hematologist

SURVIVOR'S ANSWER: In 1998, I had a Grand Mal seizure and was rushed to the hospital where a CT scan determined that a brain tumor was the cause. The biopsy was read, and I was diagnosed with a malignant anaplastic astrocytoma. I underwent major radiation twice daily as advised based on the diagnosis. I then was offered the opportunity to go to M.D. Anderson in Houston for chemotherapy. When I got to M.D. Anderson, I was informed by my neurologist there that I had been misdiagnosed. The diagnosis actually was an anaplastic oligodendronglioma. I was then told by the same neurologist that M.D. Anderson would not have done any radiation at all because an oligodendroglioma is not nearly as sensitive to radiation as it is to chemo. I underwent about 10 months of M.D. Anderson chemotherapy protocol administered here in Lafayette by extremely competent nurses supervised by and an equally competent physician. I do not stand in judgment of anyone. I am merely stating my experience as it happened.

I believe second opinions are invaluable and crucial when there is any question by the patient about the original diagnosis. My recommendation is at all times follow your intuition, your gut instinct. I have told everyone who has ever approached me, to seek a second, and even a third opinion when not comfortable.

- Peter Bulliard