Second Opinions
Second opinions can mean second, third, and even fourth opinions until you feel that your decision has been confirmed by multiple doctors and you have peace about moving forward.
Our oncologists were both supportive of us getting second opinions, which was wonderful. For Joel, we went to MD Anderson Cancer Center in Houston, Texas; Memorial Sloan Kettering Cancer Center in New York; and our local Cleveland Clinic. Similarly, we sought second opinions for me from Miami Cancer Institute and Memorial Sloan Kettering Cancer Center.
Accept help from someone you trust to organize the details of your appointments and travel. I didn't ask for help, and I had so much on my plate that I once booked the wrong airline tickets for our flight home. UGH!
It can also be overwhelming to gather medical records and submit all of the required information through a hospital's portal. That's another area where a trusted family member or friend can help. There are so many ways your support team can lighten your load, but you have to be willing to ask for help. Don't be stubborn like me and think you can do it all yourself! Visit the Assemble page to learn more.
MD Anderson CANCER CENTER in Houston, Texas
Six weeks after Joel's surgery, we flew to Houston, Texas, to visit MD Anderson Cancer Center. His oncologists were all in favor of him getting a second opinion. Joel went through a battery of tests, and then we met with several oncologists to discuss chemotherapy. They gave us the same recommendation as our local hospital. This confirmation was important for me because I was concerned about Joel doing conventional treatment.
Second opinion at MD Anderson hospital in Houston, Texas - six weeks after Joel's surgery.
While we were there, we also met with a radiation oncologist. He felt that although radiation could be beneficial in Joel's situation, there were also risks to consider, including potential long-term effects and the possibility of additional adhesions and bowel complications. At that appointment, Joel decided to table the discussion of radiation until chemotherapy was completed. This was consistent with the recommendation of his local radiation oncologist.
Cleveland Clinic IN WESTON, FLORIDA
Our local Cleveland Clinic was about an hour’s drive from our home, but Joel strongly considered doing his chemotherapy there because he liked the oncologist so much. Ultimately, Joel chose to receive treatment closer to home and work.
Memorial Sloan Kettering CANCER CENTER in New York
Second opinion at Memorial Sloan Kettering hospital in New York.
Joel was tired and weak as he went in for one of his final chemotherapy treatments. He asked his oncologist whether we should go to Memorial Sloan Kettering for a third opinion regarding radiation.
The oncologist said, “Yes! That's exactly what I was thinking. There is a well-respected doctor there. I went to school with him, and I recommend you see him, but I'm not sure you'll be able to get an appointment. He is one of the lead doctors for colon cancer at Sloan. I don't have a relationship with him now, so you'll just have to try to get in with him.”
He gave us the doctor's name.
It was my job to find this doctor and set up Joel's appointment. We left the office and went into the chemotherapy room for Joel's treatment that day. It was an especially difficult treatment because he was already so exhausted.
We were blessed to be able to bring the whole family with us when we visited New York City.
After we got home and Joel went to bed, I went outside to our neighborhood community grill to make dinner. I tried to cook outside as much as possible because poor Joel was so nauseous and couldn’t tolerate the smell of food. I felt terrible for him.
It was all too much. I sat down by the grill and started crying. I couldn’t imagine another trip or more treatment for Joel.
A couple from our neighborhood was using the grill across from me. They noticed me crying and asked if I was alright. I explained that Joel had cancer, we had just gotten home from a chemotherapy treatment, and I needed to make him an appointment at Memorial Sloan Kettering.
The husband perked up and said, “Really? My brother works at Sloan Kettering.”
I asked, “What is his name?”
He said the name of the very doctor Joel’s oncologist had just recommended.
I cried even harder.
Within minutes, he was on the phone with his brother, helping us set up an appointment. It seemed too good to be true, but I believe that is called a miracle.
While getting a second opinion at Sloan Kettering, we celebrated Hannah's 18th birthday by seeing Hamilton on Broadway.
It was an amazing moment and an answer to prayer. I heard God whisper to my heart, “All will be well. I am here.” I couldn’t wait to get back inside and tell Joel that God had introduced me to the doctor’s brother.
Joel with David Jeremiah in New York.
At Sloan, we met with the doctor and his team, and they treated us like family. We believed God had led us to these appointments, and we felt so encouraged to add these specialists to Joel’s medical team. We truly felt like they were on his side, ready to fight for him and support him however he might need in the future.
While in New York, we experienced another incredible God moment.
We were standing in the lobby of our hotel when Joel whispered to me, “Julie, I think I see Dr. David Jeremiah standing over there.”
Dr. Jeremiah is a Christian author, pastor, and two-time cancer survivor. My parents had given Joel Dr. Jeremiah’s book, When Your World Falls Apart, and it had encouraged him tremendously. We also listened to Dr. Jeremiah’s messages on Sundays. Of all the things Joel had read and listened to over the past year, Dr. Jeremiah’s books and sermons had been among the most influential in his spiritual journey.
Joel said, “I’m going over to say hi to him.”
Sure enough, it was David Jeremiah! He and Joel talked for a while, and before he left, he prayed with our family.
Dr. Jeremiah had become such an important part of Joel’s spiritual journey, and there he was, casually standing in the middle of a busy hotel lobby in New York City. What a providential experience! Once again, God reminded us that He was walking through the valley with us.
Miami Cancer Institute
Meeting with an oncologist and geneticist at Miami Cancer Institute to learn more about the cancer gene that I carried.
About a month after my second surgery, we went to Miami Cancer Institute to seek a second opinion. We lived just over an hour away. We met with an oncologist who strongly encouraged me to consider radiation and hormone therapy, especially since I was adamantly opposed to chemotherapy.
That same morning, I started a 24-hour urine test that my general doctor had ordered to check my cortisol levels. We had to carry around a large orange container everywhere we went that day! They gave us a bag to carry it in and filled it with ice packs to keep the urine cool.
Joel was being a sweetheart and carried the bag for me. After sitting in the waiting room for quite some time, he looked down and noticed a wet spot on his pants. For a brief moment, we thought it was my urine! Then we realized it was just the ice packs leaking. We could not stop laughing! He spent the rest of the day patiently and continuously cleaning up the leaky bag.
When we finally got in to see the oncologist, she was amazed that Joel had all of my paperwork organized in a notebook and could immediately produce whatever document she needed. I silently thanked God for Joel, who was walking by my side through this journey—and even carrying my urine!
The hilarious moment at Miami Cancer Institute was captured!
We later returned to Miami Cancer Institute to meet with a genetics specialist to discuss genetic testing and my family history. My breast cancer diagnosis had seemingly come out of nowhere and had been a complete shock to our family, so we wanted to find out whether I might carry an inherited genetic variant associated with an increased risk of cancer. Read “Cancer Gene Shocker” for more about this.
MEMORIAL SLOAN KETTERING
I also reached out to Memorial Sloan Kettering for another opinion. Since it was during COVID-19, I was able to have the consultation virtually, although the appointment took longer than usual to schedule.
As time passed while I waited for the virtual appointment, I was becoming increasingly certain about my decision not to have chemotherapy. During the appointment, the oncologist strongly recommended chemotherapy, radiation, and hormone therapy.
I had already decided in my heart not to do chemotherapy, but the strength of the oncologist’s recommendation definitely caused me to think carefully through my decisions regarding radiation and hormone therapy.
LOCAL ONCOLOGIST
Another local oncologist was concerned about my decision not to pursue chemotherapy, radiation, or hormone therapy, particularly because I had been premenopausal at the time of my diagnosis and my Ki-67 was greater than 20%.
Ki-67 is a marker used to estimate how quickly tumor cells are dividing. A higher Ki-67 generally indicates that more cancer cells are actively dividing and may suggest a more rapidly growing tumor. However, there is no single universally accepted cutoff for what constitutes a low, intermediate, or high Ki-67, and results are interpreted alongside other characteristics of the cancer.
What these second opinions did for me was twofold: I needed to hear these opinions to fully get on board with Joel’s treatment decisions and give him the support he needed and deserved. They also helped me make my own treatment decisions and, especially, strengthened my motivation to live as healthfully as possible and get my stress under control.
In the end, although seeking multiple opinions was time-consuming, it gave us peace of mind knowing that we had done our due diligence and carefully considered our decisions. Even when we ultimately chose not to follow some of the recommendations, it was important for us to hear the different perspectives, weigh the potential benefits and risks, ask questions, and make informed decisions about how to move forward. Visit the Treatment page to learn more about seeking second opinions.
