Importance of Maintaining Doctor-Patient Dialogue & Securing Second Opinions

Importance of Maintaining Doctor-Patient Dialogue & Securing Second Opinions

Video Presented By Dr. Douglas B. Evans, MD, FACS
Chair of The Department of Surgery at the Medical College of Wisconsin and
Professor of Surgery at the Donald C. Ausman Family Foundation of Surgery

A pancreatic cancer diagnosis can throw a patient’s life into emotional turmoil and a high level of anxiety. Careful timing must be kept in-mind although a steady doctor-patient dialogue in the days, weeks and months that follow helps patients develop a better understanding of their circumstances and options.

Maintaining a doctor-patient dialogue involves more than just the pancreatic cancer patient – often, the patient’s loved ones and caregivers are the ones to ask those important questions, particularly those questions relating to prognosis that may be too fearful or emotional for the patient to ask.

Questions About Prognosis

A newly diagnosed pancreatic cancer patient may be reeling from the news and hesitant to ask about prognosis because he or she may not be mentally or emotionally prepared to hear the answer. That same patient’s family members, loved ones and caregivers may want and need answers about prognosis, but they must be sensitive to the needs and desires of the patient when seeking them.

Under these circumstances, a patient’s loved ones may choose to meet with the doctor apart from the patient to get the answers they need while maintaining sensitivity to the patient’s wishes. It is important that loved ones understand that, when it comes to questions about prognosis, doctors do their best to offer the most accurate information available. When giving a patient a prognosis, physicians typically reference the average anticipated survival of a large population of patients facing similar circumstances, so the figure may or not be accurate for each individual patient.

The Value of Second Opinions

While it’s important that patients and their loved ones keep the conversation going with their physicians, it’s equally important that patients pursue second opinions after receiving serious medical diagnoses.

When possible, patients may want to seek those second opinions from large-scale academic medical centers with a wide variety of cancer programs in place, as opposed to from smaller hospitals. While both settings prioritize treating the “patient of today,” academic medical centers are more likely to also focus on treating the “patient of tomorrow,” meaning they may place a heavier emphasis on clinical trials and new and innovative treatment options. When patients seek second opinions from larger research centers, they may, too, have their cases brought before a multidisciplinary board of physicians, none of whom have an existing emotional attachment to the patient.

When seeking second opinions, though, it’s important to be aware of “analysis fatigue.” When patients get opinions from five, six, seven or more doctors, rather than two or three, it may hurt them in the long run. Why? It may lead a patient to consider a wide number of treatment options, which in turn may delay that patient from receiving prompt treatment when it might prove most effective. Securing second or third opinions helps increase the accuracy of diagnostics while improving not only the patient’s chances of survival, both those of future patients, too.

About Dr. Douglas B. Evans, MD

Doctor Douglas B. Evans is a world-renowned pancreatic cancer and endocrine cancer surgery, oncologist and clinical researcher specializing in pancreatic cancer at Froedtert & Medical College of Wisconsin. He has been distinguished as one of the top 5 pancreatic surgeons in the world.

Douglas B. Evans, MD is the Chair of the Department of Surgery at The Department of Surgery at The Medical College of Wisconsin and Professor of Surgery at the Donald C. Ausman Family Foundation. Prior to joining the Medical College of Wisconsin in 2009, he was the Hamill Foundation Distinguished Professor of Surgery at The University of Texas MD Anderson Cancer Center. He is board-certified in surgery, and his clinical interests include treatment of pancreatic cancer and tumors of the endocrine system (thyroid, parathyroid, adrenal and gastrointestinal neuroendocrine tumors). Dr. Evans holds appointments at Froedtert Hospital, the Clement J. Zablocki VA Medical Center and Children’s Wisconsin.

Dr. Evans is a fellow of the American College of Surgeons, and a member of the editorial boards of Surgery and The American Journal of Surgery. He is past Editor of the Pancreatic Tumors Section of the Annals of Surgical Oncology. He served on the editorial board for the seventh edition of the AJCC (American Joint Committee on Cancer) Cancer Staging Manual and chaired the committee that revised the staging system for pancreatic cancer.

Dr. Doug Evans has authored or co-authored over 400 journal articles, over 90 book chapters and has edited eight books. He has delivered countless invited and named lectureships nationally and internationally. He served as the President of the American Association of Endocrine Surgeons in 2010-2011. Dr. Evans was awarded the American College of Surgeons Traveling Fellowship to Australia and New Zealand in 1999.

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