Second Opinion
How to get a cancer second opinion
Getting a second opinion on a cancer diagnosis or treatment plan is routine — not adversarial. Studies in peer-reviewed journals 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.
- Recent pathology report. Pathologists sometimes disagree; one review by the Johns Hopkins pathology department found second review changed diagnoses in 11% of cases.
- You're choosing between treatment options. Different specialists weight surgery, radiation, and systemic therapy differently.
- You want access to a clinical trial that may not be available at your current institution.
- You simply want confidence in the plan before starting months of treatment.
Virtual vs in-person second opinions
Virtual second opinions are 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 second opinions include a physical exam and typically a tumor-board review. More thorough but require 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 in-person consultation.
How to request a virtual second opinion
- Pick the center — ideally an NCI-designated cancer center with specific expertise in your cancer type.
- Contact their second-opinion intake. Most centers have a dedicated portal. Major programs include: Memorial Sloan Kettering, Dana-Farber, MD Anderson, Mayo Clinic, Cleveland Clinic, Johns Hopkins.
- Gather your records. You'll need your pathology report, imaging (CT/MRI/PET), operative notes if any, treatment history, and current oncologist's contact info.
- Submit and wait. Most programs return a written opinion within 2 weeks. Some faster for urgent cases.
- 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 Patient Advocate Foundation and CancerCare may help cover it.