There are times during your child’s treatment when getting a second opinion may be advisable. Parents are sometimes reluctant to request a second opinion because they are afraid of offending their child’s doctor or creating hard feelings. The majority of doctors will not resent a parent for seeking a second opinion. If your child’s doctor does resist, ask why. Second opinions are a common and accepted practice, and they are sometimes required by insurance companies.

There are two ways to get a second opinion: see a pediatric oncologist at a different center of excellence or ask your child’s doctor to arrange for your child’s situation to be discussed at the tumor board. Many parents seek a second opinion at the time of diagnosis, but it is better not to do this in secret. Explain to your child’s pediatric oncologist that, before proceeding, you would like an additional viewpoint. To allow for a thorough analysis, arrange to have copies of all records, test results, and pathology slides sent ahead to the doctor who will give the second opinion.

Personally, I feel there is nothing wrong with getting a second opinion from another major center. If you like and feel comfortable with your current team, that’s great, but I definitely do not like when a doctor tells us there’s “no reason” to go elsewhere, that “they can’t do anything we don’t do,” and so forth. Many people travel great distances to get treatment at another facility whose treatment philosophy they prefer. And, granted, that is their choice. Now, your second opinion doctor may look at your child’s records and say, “Your team is doing exactly the right things; stick with them,” or he may tell you something totally different and then you can make your own decision on what to do.

Doctors informally seek second opinions all the time. For example, residents confer with their fellows about complicated situations. Fellows confer with the attending when unusual drug reactions or responses to treatment occur. Also, attendings call colleagues within other specialties and at other institutions. Thus, parents should feel free to ask their child’s physician whether he has conferred with other staff members to gain additional viewpoints.

Brent developed a seizure disorder after a rare drug reaction, so he was on anticonvulsants as well as chemotherapy for two years. We worried about the interaction of all the drugs, as well as the advisability of his continuing on the more aggressive arm of the protocol. We asked the fellow to arrange a care conference, and she met with us, the clinic director, and Brent’s neurologist to discuss how best to manage his case.