The Natural Connection

In the old days, illness was simple in South Georgia. You got sick, and if you didn’t get better in a few weeks you saw the doctor. The doctor did his best to come up with a diagnosis and treatment plan. You followed his advice, no questions asked. 

If he (in the old days most doctors were “he”) was right, you got better. If he was wrong, you got worse. Simple. Not always good, perhaps, but simple. 

Sometime in the past ten years or so, things changed. Now patients want to participate in their health care decisions. They demand information, answers, and choices. They know that the M.D. on their doctor’s lapel does not stand for Medical Deity anymore. Not simple at all, but good.  

There is no argument that the practice of medicine has become exponentially complex. The virtual explosion of medical information occurring over the past decade makes it impossible for any single physician to be totally versed in all available treatments for every available medical condition. But most times, when the illness is common, simple, and not life threatening, common treatments will still suffice. 

However, when the diagnosis is cancer, patients will tell you that things are often anything but simple and good. One of the biggest challenges of medicine still remains how to insure that all cancer patients are offered timely, appropriate, and compassionate care. 

Major teaching hospitals have stepped forward in recent months with good news for cancer patients. New research indicates that many patients benefit from second opinions from what are called multidisciplinary centers. Unlike the traditional approach to cancer, where the patient is given a diagnosis and treatment plan from one physician, this new concept allows the patient to receive the advantage of an opinion of a team of doctors who have evaluated all the information about the patient’s cancer.  

In a surprising number of cases evaluated at such centers, the initial diagnosis or treatment recommendation is changed. The American Cancer Society reported in April 2001 that in a group of 75 women with breast cancer referred to a multidisciplinary center at the University of Pennsylvania, the specialist team disagreed with the referring physician’s treatment recommendations in 43% cases. 

Similar results were noted by the Department of Urology at the University of North Florida in Gainesville and reported this summer in the Journal Urology. UF researchers studied the records of 150 patients referred by urologists in private practice and from other hospitals who had the diagnosis of bladder or prostate disease. Of the 150 cases evaluated, there was disagreement in 29 cases, or nearly 20%. Four patients who were originally diagnosed to have cancer, in fact did not, while another four who were thought to have benign disease, in fact had malignancies.

Based on findings such as these, Harvard University recommended to the to the general public in July 2001 that patients consider asking their doctor to refer them for a second opinion whenever the following situations are encountered: 

It is important to realize that the advice you receive from a second opinion is not necessarily better than the first, and you will need to determine with the help of your doctors which is the best course of action for you. It is helpful to write a list of your questions before the appointment. Some things you will want to know include: 

Lastly, you should never be embarrassed or afraid to ask your doctor to help you get more information about a serious illness like cancer. Information is the only way that you will be able to make the choices that are right for you. Not always simple, but good. 

For information on how to contact a regional multidisciplinary cancer center in your area, write to The Natural Connection, c/o Pauline Bellecci, MD, PO Box 777, Waycross, GA 31502 or visit our web site www.swampdocs.com 

©2000-2003 Pauline M. Bellecci, MD