Do You Need a Second Opinion? The Value of Second Opinions with Cancer Diagnosis

November 19, 2021
Do You Need a Second Opinion? The Value of Second Opinions with Cancer Diagnosis

Written by Krystina Wales


Medical diagnoses and evaluations are made based on science. Patients often put their complete trust in the medical expertise and knowledge of these professionals without reflecting on one key factor: that they are human too. 

With all the knowledge in the world, there is still an opportunity for human error, even in a medical diagnosis. Pathologists are the medical specialists responsible for evaluating samples of bodily tissue in a lab, determining if a cancer is present and what type and stage this cancer is at. According to a 2000 New York Times article, they can (and do) get things wrong sometimes. 

According to a study published in the November 2000 edition of Cancer, pathologists misdiagnosed 1.4 percent of cases, which could have led to unnecessary treatment for patients. (Editor’s note: A similar study conducted in 2009 looking at pathologic diagnoses in cytology cases found a similar percentage – 1.2 percent.)

Several factors contribute to this issue. As procedures for extracting tissue become less invasive, the sample size provided to the pathologist for evaluation becomes smaller, therefore becoming more difficult to detect potential malignancies. Additionally, treatment options grew in both volume and specificity, which made staging and typing more of a nuanced process.

With the breadth of knowledge and specificity needed to properly catalogue these diagnoses, even the most experienced pathologist can make an error. While the percentages are low, the best course of action to prevent misdiagnosis, as well as unnecessary treatment, is a second opinion.

Some healthcare organizations and hospitals have adjusted their own protocols and procedures to incorporate a second opinion on samples, especially with less experienced pathologists and contracted pathologists. It is recommended an in-house pathologist do a second review when possible.

Additionally, second opinions are recommended on those cancers which have a higher likelihood of misdiagnosis: gynecologic and lymphatic.

With the development of tumor boards, many healthcare organizations build in a multi-disciplinary team of evaluators whose job is to provide a second set of eyes and opinions to a diagnosis and treatment plan.

Be open to asking an oncologist about the specific protocols at your hospital and requesting a second opinion on sample reviews. And, as always, decisions about healthcare are ultimately up to a patient. When it comes to a decision about major surgery or potentially life-altering treatment options, the cost of a second opinion can be worth it. 

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