Why do newly diagnosed breast cancer patients seek a second opinion? – Second opinion seeking and its association with the physician-patient relationship

Cecon, Natalia; Hillen, Marij A.; Pfaff, Holger; Dresen, Antje; Groß, Sophie E.

doi:10.1016/j.pec.2018.12.017

Cited by 19 publications

(16 citation statements)

References 24 publications

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“…For a limited number of rare cancers, centralization of care is present, because of which these physicians are aware of the hospital that provides the best care for this patient. Previous studies on second opinions in breast cancer patients showed that physicians specifically inform those patients who are highly educated and more involved in the decision-making process, and these patients were also more likely to request a second opinion [ 36 , 37 ]. Accordingly, patients with RC in our study had a higher level of education than CC patients, and thus might be more inclined to learn about second opinion options, or request such an opinion themselves.…”

Section: Discussionmentioning

confidence: 99%

Differences in health care experiences between rare cancer and common cancer patients: results from a national cross-sectional survey

Heus

Engelen

Dingemans

et al. 2021

Orphanet J Rare Dis

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Background Patients with rare cancers face challenges in the diagnostic and treatment phase, and in access to clinical expertise. Since studies on health care experiences of these patients in comparison to patients with more common cancers are scarce, we aimed to explore these differences. Methods Data were cross-sectionally collected among (former) adult cancer patients through a national online survey in the Netherlands (October 2019). Descriptive statistics were reported and subgroups (rare vs. common patients) were compared. Results In total, 7343 patients (i.e., 1856 rare and 5487 common cancer patients) participated. Rare cancer patients were more often diagnosed and treated in different hospitals compared to common cancer patients (67% vs. 59%, p < 0.001). Rare cancer patients received treatment more often in a single hospital (60% vs. 57%, p = 0.014), but reported more negative experiences when treated in multiple hospitals than common cancer patients (14% vs. 9%, p < 0.001). They also more often received advise from their physician about the hospital to go to for a second opinion (50% vs. 36%, p < 0.001), were more likely to choose a hospital specialized in their cancer type (33% vs. 22%, p < 0.001), and were more willing to travel as long as necessary to receive specialized care than common cancer patients (55% vs. 47%, p < 0.001). Conclusions Rare and common cancer patients differ in their health care experiences. Health care for rare cancer patients can be further improved by proper referral to centers of expertise and building a clinical network specifically for rare cancers.

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Section: Discussionmentioning

confidence: 99%

Differences in health care experiences between rare cancer and common cancer patients: results from a national cross-sectional survey

Heus

Engelen

Dingemans

et al. 2021

Orphanet J Rare Dis

View full text Add to dashboard Cite

show abstract

“…For a limited number of rare cancers, centralization of care is present, because of which these physicians are aware of the hospital that provides the best care for this patient. Previous studies on second opinions in breast cancer patients showed that physicians speci cally inform those patients who are highly educated and more involved in the decision-making process, and these patients were also more likely to request a second opinion [33,34]. Accordingly, patients with RC in our study had a higher level of education than CC patients, and thus might be more inclined to learn about second opinion options, or request such an opinion themselves.…”

Section: Interpretation Of Ndingsmentioning

confidence: 57%

Differences in Health Care Experiences Between Rare Cancer and Common Cancer Patients: Results From a National Cross-Sectional Survey

Heus

Engelen

Dingemans

et al. 2020

Preprint

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Background Patients with rare cancers face challenges in the diagnostic and treatment phase, and in access to clinical expertise. Since studies on health care experiences of these patients in comparison to patients with more common cancers are scarce, we aimed to explore these differences.Methods Data were cross-sectionally collected among (former) cancer patients through a national online survey in the Netherlands (October 2019). Descriptive statistics were reported and subgroups (rare vs. common patients) were compared.Results In total, 7,343 patients (i.e., 1,856 rare and 5,487 common cancer patients) participated. Rare cancer patients were more often diagnosed and treated in different hospitals compared to common cancer patients (67% vs. 59%, p<0.001). Rare cancer patients received treatment more often in a single hospital (60% vs. 57%, p=0.014), but reported more negative experiences when treated in multiple hospitals than common cancer patients (14% vs. 9%, p<0.001). They also more often received advise from their physician about the hospital to go to for a second opinion (50% vs. 36%, p<0.001), were more likely to choose a hospital specialized in their cancer type (33% vs. 22%, p<0.001), and were more willing to travel as long as necessary to receive specialized care than common cancer patients (55% vs. 47%, p<0.001).Conclusions Rare and common cancer patients differ in their health care experiences. Health care for rare cancer patients can be further improved by proper referral to centers of expertise and building a clinical network specifically for rare cancers.

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“…Cancer patients are confronted with a life-threatening disease, leading to considerable distress [ 1 ]. For many patients, the diagnosis involves complex decision-making about treatment and substantial uncertainty regarding their prognosis, i.e., the (in)curability of the disease and life expectancy [ 2 , 3 , 4 , 5 , 6 ]. Information about prognosis generally includes a high degree of uncertainty, as the precision of prognostic estimates and their predictive values for individual patients are limited [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Communication about Prognosis during Patient-Initiated Second Opinion Consultations in Advanced Cancer Care: An Observational Qualitative Analysis

Velden

Kleij

Lehmann

et al. 2021

IJERPH

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Prognostic communication is essential for patients with advanced cancer to enable informed medical decision-making and end-of-life planning. Discussing prognosis is challenging, and might be especially complex for oncologists conducting a second opinion (SO). Survival data are often lacking, and consulting oncologists need to consider previously conveyed information and patients’ relationship with the referring oncologist. We qualitatively investigated how advanced cancer patients and consulting oncologists discuss prognosis during audio-recorded SO consultations (N = 60), including prognostic information received from the referring oncologist. Our results show that patients regularly expressed implicit cues to discuss prognosis or posed explicit questions tentatively. Consulting oncologists were mostly unresponsive to patients’ cues and cautious to prognosticate. They also seemed cautious when patients brought up the referring oncologist. Consulting oncologists checked which prognostic information patients had received from the referring oncologist, before estimating prognosis. They agreed with the first opinion or rectified discrepancies carefully. Altogether, this study exposes missed opportunities for open prognostic discussions in SOs. Consulting oncologists could explicitly explore patients’ information preferences and perceptions of prognosis. If desired, they can provide tailored, independent information to optimise patients’ prognostic awareness and informed medical decision-making. They may additionally support patients in dealing with prognosis and the uncertainties associated with it.

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Why do newly diagnosed breast cancer patients seek a second opinion? – Second opinion seeking and its association with the physician-patient relationship

Cited by 19 publications

References 24 publications

Differences in health care experiences between rare cancer and common cancer patients: results from a national cross-sectional survey

Differences in health care experiences between rare cancer and common cancer patients: results from a national cross-sectional survey

Differences in Health Care Experiences Between Rare Cancer and Common Cancer Patients: Results From a National Cross-Sectional Survey

Communication about Prognosis during Patient-Initiated Second Opinion Consultations in Advanced Cancer Care: An Observational Qualitative Analysis

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