Cancer treatment is inherently complex, with different types of cancer requiring different treatment paths. Likewise, consider the fact that medical research advances at a rapid pace and treatment options continue to evolve. 

In such a dynamic field, a specialist’s opinion becomes even more important. Yet, surprisingly, 84% of individuals with a cancer diagnosis may not seek a second opinion¹,  potentially missing out on expertise that could refine or change their treatment path. Even more surprising is that data confirms this: discrepancies in medical opinions had a potential major impact on patient outcomes in up to 58% of cases²,  highlighting the critical role these consultations can have on patient care.

This underscores the importance of specialist insight in cancer care, including cancer second opinions and tumor board reviews. Both contribute to enhancing treatment accuracy and outcomes, ensuring that patients receive informed and precise care tailored to their specific type of cancer.

What is a Cancer Second Opinion?

A cancer second opinion provides individuals and their primary oncologists a chance to access specialized experts for a thorough reevaluation and review of their diagnosis and treatment plans. This process goes well beyond simply confirming or refining the initial diagnoses. While this is an important component, perhaps even more important is that the oncology second opinion also confirms, adapts, or refines treatment options, ultimately providing peace of mind.

Advantages of Seeking a Second Opinion

Many leading cancer hospitals offer second opinion programs available both in-person and via telehealth, which is especially beneficial for individuals in areas lacking specialized medical care (such as rural or community hospitals, for instance). 

The main advantages of seeking a second opinion include:

• Confirmation or refinement of diagnosis: This ensures the initial diagnosis is correct, making adjustments as needed.
• Modification of treatment plans: This allows for alternative treatment options to help improve effectiveness and/or reduce unnecessary treatments or procedures.
• Identification of clinical trials or emerging therapies: Offers insight into innovative treatment options–including the latest drugs and medical technologies.
• Expertise access: Provides connections to experts, particularly valuable for rare or complex types of cancer.
• Peace of mind: The shared decision-making provides greater confidence and reassurance of the best path forward.

Post-Second Opinion Outcomes

After a second opinion, individuals frequently face a decision:

• Enhancing local treatment plans: Individuals may choose to take the second opinion back to their local doctor and integrate these insights into their existing treatment plans at their local facilities. This integration often leads to more targeted and effective treatment approaches.
• Transitioning care: Some may opt to transfer their care and become patients of the facility that provided the second opinion, especially if it offers more treatment options or clinical trials not available in their current location.

In both scenarios, the second opinion is instrumental in providing individuals with more specialized care, which can lead to significantly improved health outcomes.

What is a Tumor Board Review?

Tumor board reviews, or multidisciplinary conferences (MDC), are gatherings in specialized oncology hospitals that typically meet weekly. These meetings act as a sort of second opinion, bringing together various specialists to deliberate over patient cases, evidence-based recommendations, and complex cancer presentations. Such reviews are fundamental, serving as a platform to discuss the diagnosis and treatment options for individuals with complex cases.

The Dynamics of Tumor Board Meetings

Tumor boards have been integral to cancer treatment planning for over fifty years, evolving from educational forums to critical decision-making bodies that enhance both the quality and outcomes of patient care³.  They are often essential for maintaining accreditation with healthcare standards and are recognized as the gold standard in cancer care delivery.

At these meetings, a broad spectrum of healthcare professionals, including medical oncologists, radiation oncologists, surgeons, pathologists, radiologists, genetics experts, nurses, physical therapists, and social workers, work in unison to scrutinize patient cases. The primary goals of a tumor board review include:

• Comprehensive case discussion: Leveraging the collective expertise of specialists to make sure quality care and state-of-the-art patient management is implemented.
• Consensus on treatment plans: Operating as a peer-reviewed environment to get various perspectives on the best course of action and optimal treatment strategies.
• Holistic care approach: Including advocates for other aspects of the specific patient’s physical and mental health based on their unique needs.
  
  

How to Obtain a Second Opinion

Individuals seeking a second opinion can choose from in-person or remote consultations. The process typically involves:

1. Getting a referral from either a treating doctor or through a self-referral
2. Checking whether the second opinion is covered by insurance or will be an out-of-pocket expense
3. Compiling all medical records, clinical notes, relevant test results, and imaging, which can be done by the individual or facilitated through institution-to-institution transfers. These records can be submitted physically or uploaded digitally for telehealth services.

Understanding Your Next Step

Both options provide critical insights but serve different purposes and apply in different situations. Tumor board reviews, for example, may not be available to every cancer patient and are typically initiated by a care team for complex cases, often within a specialized cancer center. 

Second opinions, on the other hand, are more accessible and can be sought from various hospitals. Remote second opinions are particularly beneficial for those seeking expert advice without the inconvenience of traveling. 

For many, the next step depends on their situation, what’s available, the complexity of the case, and how much input they’re seeking. Some patients may benefit from both approaches at different points in their care journey.

 What are AccessHope Expert Case Reviews? 

While traditional second opinions and tumor board reviews remain valuable tools, there’s growing recognition that new models—like AccessHope’s Expert Case Reviews—can extend the reach of specialized expertise more efficiently and proactively.

AccessHope integrates expert reviews into cancer support, offering remote case reviews that connect members to expertise from leading cancer specialists, without travel or effort. These reviews can be requested by the member or proactively identified by leveraging claims data with no member opt-in required. Our subspecialists are knowledgeable in the latest cancer research and innovations, supporting the member and their oncologist by providing insights that they may use to optimize the treatment plan.

Our Accountable Precision Oncology service provides proactive evidence-based recommendations associated with improved clinical and humanistic outcomes, including identification of appropriate clinical trials and targeted therapies. Likewise, through our member-initiated Expert Advisory Review service, we aim to ensure that all members, regardless of location, can benefit from high-quality oncology expertise and personalized support tailored to their specific conditions.

References

¹ Olver, Ian., Carey, Mariko., Bryant, Jamie., Boyd’s, Allison., Evans, Tiffany., Sanson-Fisher, Rob. BMC. Second opinions in medical oncology. https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-020-00619-9. Published July 21, 2020. Accessed May 20, 2023.

² Katella, Kathy. Yale School of Medicine. Can a Second Opinion Make a Difference? https://medicine.yale.edu/news-article/can-a-second-opinion-make-a-difference/. Published January 14, 2020. Accessed May 20, 2023.

³ Hammer, Richard., Fowler, Donna., Sheets, Lincoln., Siadimas Athanasios., Guo Chaohui., Prime, Matthew. JCO Clinical Cancer Informatics. Digital Tumor Board Solutions Have Significant Impact on Case Preparation. https://ascopubs.org/doi/10.1200/CCI.20.00029. Published August 20, 2020. Accessed May 20, 2023.