Did you hear about Rita Wilson? FBC. Yep. I was as surprised as you are. Having been in her shoes – well, not exactly in her shoes as I certainly am not a public figure – I understand how hard it is to share personal and difficult news with family and friends. However, the Silver Lining is that sharing these experiences helps so many others who are facing the same
Rita’s story is very different than mine in that she knew that she had an underlying condition of lobular carcinoma in situ (which is abnormal cell growth in the milk glands of the breast). In other words, this is considered pre-cancer and the majority of the time, people are monitored closely, but no treatment is required.
So, after years of monitoring in the form of breast MRI’s and mammograms, two recent surgical breast biopsies revealed pleomorphic carcinoma in situ. “Pleomorphic” means that the LCIS cells look more atypical under the microscope than the usual case of LCIS. However, her pathology report was clear and showed no cancer.
A friend of Rita’s suggested to her that she get a second opinion (ding-ding-ding #1!) on her pathology report. Rita’s gut told her it was the right decision (ding-ding-ding-ding #2!). The BEST part is that Rita followed her intuition. And sure enough, a different pathologist found invasive lobular carcinoma. In other words, her abnormal cells became cancer cells. This new pathologist’s diagnosis was confirmed by yet another pathologist.
Immediately, Rita underwent a bilateral mastectomy and reconstruction. Rita said in People, “I share this to educate others that a second opinion is critical to your health. You have nothing to lose if both opinions match up for the good, and everything to gain if something that was missed is found, which does happen. Early diagnosis is key.”
In light of this second opinion talk, this reminded me of a blog that I wrote when I was going through a similar situation. For those of you who are newer to the blog, I hope you find it helpful. And for those who are veterans, please let it serve as a helpful reminder.
Second Opinions During F-Bomb Breast Cancer
I am a big — humongous — believer in getting second opinions. There is no better or more important time in your life to have as much data and experience contributing to your health care as there is NOW.
No, you are NOT “cheating” on your primary doctor by getting a second opinion. Pinky promise. In fact, the best doctors will make recommendations and wholeheartedly support your pursuit of a second opinion.
Here’s the thing, though, if you get a second opinion, you have to be prepared for the possibility of differing (or even conflicting) opinions. One of the unexpected frustrations (as if there are not enough!) of having FC (f-bomb cancer) or any other medical f-bomb in your life is when doctors and other health care professionals have differences in perspectives and opinions. This situation can unfortunately create some real (internal) conflict.
Here’s what you can expect when getting a second opinion:
- You will need to get all of your medical records (sometimes including pathology slides…which is a bit of a pain in the tush, but worth it) delivered to the consulting doctor. Make sure that YOU do it. Don’t make any assumptions that this person or that person will do it. The Silver Lining is that with the move toward electronic medical records, many can be sent via email.
- You may need to get additional tests, answer an array of the same questions you’ve already answered a million times and have a physical examination. Don’t let this frustrate you, please. It’s part of the process. One thing is for sure: be leary of any doctor willing to give you an opinion without doing a physical exam.
- Insurance coverage isn’t a guarantee. If your insurance doesn’t cover the second opinion, you will be responsible for paying for it. Sorry for that bad news, but better to know on the front end than be surprised by it at checkout time.
So, WTF do you do if you get a second opinion that differs (either in a big way or in a small one)?
- First of all, separate emotion. Don’t make your decision based on which doctor is “nicer” or treats you this way or that. While I wish that all doctors were created with a wonderful bedside manor, some just aren’t. As they say (on Dragnet): “Just the facts, Ma’am. Just the facts.”
- If there are differing opinions, ask the doctors to talk to one another. This is a totally reasonable option and it happens all the time. I know this because as a nurse I’ve seen it!
- If the doctors cannot come to an agreement, you may want to consider a third opinion. I know it’s not what you want to do, but it could be worth your effort.
- Don’t assume. Ever. But especially now. The second opinion isn’t automatically the correct one, nor is the opinion that delivers better news.
- The most important thing that you can do is to trust your intuition. There is no better voice than your own. You are the ONLY one who knows what your body can handle and when. Allow your intuition to lift you up and take a seat at the decision making table because it’s the most important voice in the room!
Getting a second opinion is very empowering way to advocate for your own care which is the ultimate Silver Lining when contending with a serious illness.