CancerDrs

Second Opinion

How to get a cancer second opinion

Getting a second opinion on a cancer diagnosis or treatment plan is routine — not adversarial. Peer-reviewed studies have found that second opinions change the diagnosis or treatment recommendation in 10–30% of cases. Most top cancer centers offer virtual second opinions; many are covered by insurance or available at a flat fee.

Why consider a second opinion

Rare or complex cancer

Diagnoses and treatment options for less common cancers vary meaningfully across institutions.

Pathology review

Pathologists sometimes disagree. A Johns Hopkins review found second pathology review changed the diagnosis in 11% of cases. Source.

Choosing between treatments

Different specialists weight surgery, radiation, and systemic therapy differently.

Clinical-trial access

You may want access to a trial that is not open at your current institution.

Confidence in the plan

Before starting months of treatment, an independent review can confirm the plan is sound.

Virtual vs in-person

Virtual

Document-based. You submit pathology slides, imaging, and records; the reviewing institution sends a written opinion within 1–2 weeks. No travel. Usually a flat fee; many insurance plans now cover them.

In-person

Includes a physical exam and typically a tumor-board review. More thorough but requires travel and usually a longer wait.

For most patients, virtual is the right first step. If the virtual opinion raises questions or proposes a very different plan, then travel for an in-person consultation.

How to request a virtual second opinion

  1. 1

    Pick the center

    Ideally an NCI-designated cancer center with specific expertise in your cancer type.

  2. 2

    Contact their intake team

    Most centers have a dedicated portal. Major programs include MSKCC, Dana-Farber, MD Anderson, Mayo Clinic, Cleveland Clinic, and Johns Hopkins.

  3. 3

    Gather your records

    Pathology report, imaging (CT, MRI, PET), operative notes if any, treatment history, and your current oncologist’s contact info.

  4. 4

    Submit and wait

    Most programs return a written opinion within 2 weeks. Some faster for urgent cases.

  5. 5

    Discuss with your local oncologist

    The second opinion is a tool for shared decision-making — not a replacement for your care team.

What does it cost?

Costs vary widely by center. Virtual second opinions are typically in the range of several hundred to a few thousand dollars when self-pay. Many plans cover some or all of the cost — call your insurance to confirm before submitting.

If cost is a barrier, patient advocacy nonprofits including the Patient Advocate Foundation and CancerCare may help cover it.

Programs at major cancer centers

Cost, format, and turnaround differ a lot. Verify pricing on each hospital's page before you submit.

By cancer type