🔍 Getting a Second Opinion

❓ Why Get a Second Opinion?

Getting a second opinion isn't about distrust — it's about making sure you have the best information for important decisions:

• Treatment options vary: Different centers may recommend different approaches based on their expertise and available trials
• Clinical trials: Major centers have access to cutting-edge treatments not available elsewhere
• Surgical expertise: Surgeons at high-volume centers often achieve better outcomes
• Pathology review: Tumor diagnosis and molecular testing can affect treatment — having an expert center review is valuable
• Peace of mind: Confirming the diagnosis and treatment plan helps you move forward with confidence

🏥 Top GBM Treatment Centers

These centers have dedicated neuro-oncology programs, high case volumes, and active clinical trial programs:

Other Excellent Centers

• UCLA Brain Tumor Center — Los Angeles, CA
• Northwestern Medicine — Chicago, IL
• University of Pittsburgh Medical Center — Pittsburgh, PA
• University of Washington/Fred Hutch — Seattle, WA
• Moffitt Cancer Center — Tampa, FL
• Stanford Medicine — Palo Alto, CA
• Penn Medicine — Philadelphia, PA

📋 How to Get a Second Opinion

💻 Telemedicine Options

Can't travel? Many major centers offer virtual second opinions:

📝 What to Bring to Your Appointment

• MRI scans on CD/DVD (all scans, not just most recent)
• Pathology slides (actual tissue, not just report)
• Pathology report including molecular testing
• Operative report (if surgery was done)
• Radiology reports
• Current medication list
• Medical history summary
• Insurance cards
• Photo ID
• List of questions you want to ask
• Notebook for notes (or ask permission to record)
• A support person (family member or friend)

❓ Questions to Ask

About Diagnosis

• Do you agree with the diagnosis after reviewing the pathology?
• What is the grade and molecular profile of my tumor?
• Is MGMT methylation testing complete? What does it mean for me?
• Is IDH mutation testing complete?

About Treatment

• What treatment approach do you recommend and why?
• How does this differ from what I was previously told?
• What are the expected benefits and risks?
• Are there clinical trials I should consider?
• What is your experience treating tumors like mine?

About Surgery (if relevant)

• How much of the tumor can be safely removed?
• What surgical techniques do you use (awake surgery, intraoperative MRI)?
• How many of these surgeries have you performed?
• What are the risks of neurological damage?

About Prognosis

• What is the expected prognosis with treatment?
• What factors in my case affect the prognosis?
• What does "success" look like for treatment?

💰 Insurance and Cost

Insurance Coverage

• Most insurance covers second opinions — especially for cancer
• Call your insurance beforehand to verify coverage
• Ask about out-of-network benefits if the center isn't in network
• Some centers have financial assistance programs

Virtual Second Opinion Costs

• Virtual consultations typically cost $500-$2,000 out of pocket if not covered
• Some may be covered by insurance — always check first
• Compared to the cost of wrong treatment, this is minimal

⏰ Timing Considerations

When to Get a Second Opinion

• After diagnosis, before treatment starts — Ideal timing
• Before major decisions — Surgery, changing treatment plan
• At recurrence — Options may be different than at initial diagnosis
• When you have doubts — Trust your instincts

Can I Wait?

GBM requires prompt treatment, but taking 1-2 weeks for a second opinion is generally safe and worthwhile. Don't let urgency prevent you from getting adequate information.

🤝 After the Second Opinion

If Opinions Agree

This is reassuring! You can proceed with confidence in your treatment plan.

If Opinions Differ

• Ask each doctor to explain their reasoning
• Consider a third opinion if differences are significant
• Look at objective factors: clinical trial access, surgical volume, specific expertise
• Trust your gut about which team you feel most confident with
• You can get treatment at the second opinion center or bring recommendations back to your local team

Sharing Results

• Request a written summary of the second opinion
• Share with your primary oncology team
• Use the information to have informed discussions about your care

🚀 Fast-Track Options

Need a second opinion quickly? Some tips:

• Explain urgency when scheduling — many centers can expedite
• Offer flexibility — say you can come any day on short notice for cancellations
• Consider virtual first — faster than waiting for in-person appointments
• Contact multiple centers — schedule with whoever can see you soonest
• Ask your current doctor to call — physician-to-physician referrals can speed things up