Oftentimes, when doctors do not agree on how to manage your situation, it is because no single “best” treatment exists. When treatments are fairly new, definitive answers about long-term risks and benefits may not be available. Each doctor’s conclusions and advice regarding your situation are based on many factors, such as his or her clinical experience (the successes and failures seen personally with various treatments)
• involvement in clinical research
• interpretation of the available data (different doctors can draw different conclusions from the same data)
The treatments being used most often in their medical center or locale (standard of care for the community) may also affect doctors’ approaches.
If you get conflicting advice, have each oncologist explain his or her advice in light of the controversy. You can determine how simple or elaborate an explanation you want or need (you do not have to learn everything about car repair to make a decision about which mechanic to use). After sorting through the various recommendations, you will feel either that there is one “best” choice or that there is more than one “right” choice.
For example, you may be in remission and your doctor feels that you have had enough treatment. If you pursue a second opinion, another oncologist may recommend an extra two months of chemotherapy “just to be safe.” Much as you would like to be done with treatment, you want to do what is best in the long run.
One possible outcome of this scenario is that you weigh the risks and benefits of each option as explained by both doctors, and proceed with the original advice. You will feel more confident about the decision to stop treatments, because you looked at your options. Consider the similar case of people buying a house who fall in love with the first one they see. The school district, floor plan, and price seem perfect. The house “feels right,” down to the telephone outlets. Still, most people would check out other houses on the market to reinforce their impression. If they find an even better house, one that “really feels right,” they will be happy that they did not sign a contract on the first house. If they come back to buy the first, they will feel surer of the decision.
Getting a second opinion and working through your options at the completion of your treatments will make you feel more comfortable when, later; you read or hear about other patients with your type of cancer who pursued one of the other treatment options. You will be more relaxed, knowing that you investigated and rejected those options as not the best for you.
Another outcome could be that the doctors providing the conflicting advice discuss the situation, after which they come to one recommendation. Or they may conclude that your options are equally good, in which case other factors (preferred doctor, treatment location, financial concerns, etc.) will determine your final decision. When there are a number of right ways to treat you, you will feel that this resolution of conflicting opinions steered you to the best treatment for you.
The most stressful outcome is that the doctors continue to disagree after discussion with you and with each other. Whom do you believe? How do you decide what is best to do? Additional second opinions (third and fourth opinions) may resolve the conflict. How you feel (your intuition) may help guide you to the best treatment choice for you. Discussing the situation with your internist may help. Usually you will end up proceeding with one option as the best of a number of options. Since not everyone can be right, you may have to dismiss the advice of one or more of the doctors in order to proceed.
There are always options at each phase of your journey with cancer. Knowledge of your options allows you to make the best choice for you with the information available.
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