Second opinions
Already diagnosed somewhere else?
Why it is normal
Asking is part of good care.
Cancer decisions are often made once and lived with for a long time. Many people want a second specialist to look at the same information before they commit to a plan, and in cancer care this is a routine request.
A good doctor is not offended by a request for a second opinion. Most expect it, and many suggest it. You do not need your current doctor's permission, although telling them can make sharing records easier.
When it helps most
Times a second look may be most useful.
Newly diagnosed, before treatment
Before treatment begins is often the simplest time to review options, because no choice has yet narrowed what comes next.
Told you need a large operation
For example, removal of the bladder, the whole kidney or the prostate. It is reasonable to confirm that the operation fits your situation and to understand any alternatives.
Offered surveillance and unsure
Watching a low-risk cancer can be a sound choice, and it can also feel uneasy. A second review may help you understand why surveillance was offered and what would change the plan.
A recurrence
If a cancer has come back, the options may differ from the first time, and a fresh review of the records may help.
A rare tumor
Some urologic cancers are uncommon, such as penile, upper tract and adrenal tumors. A review by a urologic oncologist may be helpful when a diagnosis is seldom seen.
What to send ahead
Records that make the review possible.
A second opinion depends on the information reviewed. Sending records before the visit allows them to be looked at in advance where possible.
Slides, tissue blocks and imaging discs usually come from the hospital where the tests were done, and gathering them can take time. It may help to start those requests when you book.
- Pathology report from every biopsy or surgery, and the slides or tissue blocks if they are requested
- Imaging on disc or through a patient portal (CT, MRI, PET, bone scan or ultrasound), with the written reports
- PSA or tumor marker history, with dates
- Operative notes and recent clinic notes from your current doctors
- A current medication list, including blood thinners and supplements
- Your insurance card
- A one-paragraph summary in your own words: what you were told, what you were offered, and what you most want to understand
At the visit
What happens at the appointment.
- STEP 01
Records reviewed
Your pathology, imaging and test results are reviewed. In some cases slides or scans may be reviewed again by specialists here.
- STEP 02
Examination
A history and a physical examination focused on your diagnosis.
- STEP 03
A plain explanation
What the findings mean, in plain language, including anything that remains uncertain.
- STEP 04
Options, including no treatment
Each reasonable option is discussed with its trade-offs, including surveillance or no treatment where that is appropriate.
- STEP 05
A written plan
You leave with a written summary of the recommendation and the next steps.
- STEP 06
Coordination with your team
With your permission, the findings are shared with the doctor who referred you. Your original doctor remains part of your care if you wish, and you choose where treatment takes place.
What it is not
Not a promise of a different answer.
A second opinion is an independent review, not a guarantee that the recommendation will change. Often the second specialist agrees with the first.
Agreement is a useful result too. It may give you more confidence in the plan, and you can move forward knowing the options were checked.
Where the opinions differ, the reasons are explained so that you and your doctors can weigh them together.
How to arrange it
Requesting a second opinion.
Request an appointment through UHealth scheduling, online or by phone, and say that you are seeking a second opinion for a diagnosis made elsewhere. Have your insurance card ready, and ask where to send records ahead of the visit.
Not sure this is the right clinic for your diagnosis? Read Before You Book · New Patients
Will my current doctor be offended?
A good doctor should not be. Second opinions are a routine part of cancer care, and most doctors expect them. Telling your doctor can also make sharing records easier.
Do I need a referral for a second opinion?
Self-referral is possible through UHealth scheduling. Some insurance plans may require a referral or prior approval, so it is worth checking with your plan.
Does insurance cover a second opinion?
Coverage depends on your plan. UHealth verifies coverage when the appointment is scheduled, and your insurance company can explain your own benefits.
Will I have to repeat my tests?
Not always. Recent records of good quality are often enough. Sometimes a test is repeated or added when an earlier result is unclear, out of date or not available for review, and the reason is explained to you.
How soon should I seek a second opinion?
Many urologic cancers allow time for a second opinion before treatment begins, but some situations are more urgent. Ask your current doctor how much time is reasonable in your case.
What if the two opinions differ?
The reasons for the difference are explained. It may help to share both opinions with your doctors, and in some cases a review by a multidisciplinary tumor board may be suggested.
Can I be treated here after a second opinion?
If you choose to. You may also take the recommendation back to your original team and be treated there. The decision is yours.
Can a second opinion be done without travelling to Miami?
Ask the scheduling team at (305) 243-6090 whether a video visit may be appropriate for your situation. Some situations need an in-person examination or tests.
Appointments
Schedule a consultation
Dr. Khandekar sees new and returning patients across the University of Miami Health System and Sylvester Comprehensive Cancer Center.
- SoLé Mia, North Miami
- Sylvester at Plantation
- Sylvester Main, Miami