Advice: Cancer diagnosis: how to find the right doctor and how to get a second opinion

In Germany, around 480,000 people are diagnosed with cancer every year.

Advice: Cancer diagnosis: how to find the right doctor and how to get a second opinion

In Germany, around 480,000 people are diagnosed with cancer every year. Cancer is an inconspicuous illness that can begin with a persistent cough or a lump in the chest. It often takes a long time before it is established that it is cancer that is causing the suffering. Those affected often have to endure umpteen examinations before the final diagnosis of cancer is made. But when it is determined that it is cancer, it changes the life of most people from one second to the other. The K-word evokes umpteen negative associations in most people. The shock after such a diagnosis runs deep. And with her, an infinite number of questions suddenly arise. Patients are very vulnerable in such situations and should be able to trust their doctors blindly. However, research by stern shows how investors enrich themselves with cancer patients and how pharmacists and doctors become their vicarious agents in this network.

Armed with good information and the right questions at hand, patients can prepare well for consultations with the doctor. Here you can find out what is important when choosing a clinic, how to recognize a good medical practice and how patients can get a second opinion.

Cancer is not just cancer. There are many different types of tumors and people react very differently to them. That is why there is no single cancer therapy. Thanks to advances in medicine and research, the disease does not necessarily mean a death sentence - even if this is still anchored in many minds. Cancer is a collective term for malignant tumor diseases that can be more or less threatening. Sick people always need a therapy plan that is tailored to them personally.

In addition to the relatively well-known chemotherapy, radiation and operations are often used. There is also immunotherapy, which relies on the body's own immune system to fight cancer. Targeted therapies are only effective against cancer cells with certain properties. Which therapy or which combination of therapies is used depends, among other things, on the type of cancer and the time of diagnosis.

This also means: The therapy of two lung cancer patients can differ from each other. Because: not only different types of cancer can differ from each other, even in the case of lung cancer, some tumors can grow faster than others, a patient responds well to a drug, while the same therapy does not do much for another patient. This means that personalized cancer medicine tailored to the individual patient is extremely important.

First of all, it is important that cancer patients take someone they trust with them to the doctor’s appointment. A lot of information rains down on the sick person, which often cannot be completely processed in the special situation. The Cancer Information Service advises writing down all questions beforehand so that none are forgotten. Notes are also helpful during the consultation with the doctor if questions arise afterwards. Patients should not be afraid to ask again if they do not understand something. In case of doubt, patients or the accompanying person should ask for an examination or a finding to be explained again in an understandable way.

The Cancer Lexicon of the German Cancer Society can also help with the translation of technical terms. The Cancer Information Service offers checklists with questions that cancer patients should ask themselves when planning therapy, before treatment in hospital or before participating in clinical studies.

Anyone who, after being diagnosed with cancer by Dr. If you ask Google for advice, you will be overwhelmed by the wealth of information. But be careful: health information on the Internet is of very different quality. In order to be able to assess the seriousness and quality of health information, it is important to ask yourself a few questions:

If only an opinion is stated on a website or the information advertises a product, this information should not be classified as serious and in any case you should look for information from another source. Good contact points for initial information include the German Cancer Society, the Robert Koch Institute and the Cancer Information Service.

In Germany, patients are free to choose their doctor. Several specialists are usually involved in cancer therapy: including radiologists, internists, surgeons, radiation therapists, nuclear medicine specialists, pain therapists, pathologists and laboratory physicians. Doctors can specialize in cancer from various disciplines: oncology.

Depending on the type of cancer and the severity of the disease, outpatient treatment in specialized practices or treatment in a clinic is an option. Anyone who can be treated on an outpatient basis should contact practices that specialize in the treatment of the respective type of cancer. At the German Medical Association and the Association of Statutory Health Insurance Physicians, patients can find information about the specialization of physicians and about admission to health insurance. On request, the health insurance companies can also compile lists of possible practices in the region. Those affected can find hematologists and oncologists at the professional association of resident doctors for hematology and medical oncology.

The Medical Center for Quality in Medicine has a checklist that patients can use to evaluate the quality of a medical practice. Among other things, the practice should be easily accessible for patients with questions, they should be treated with respect, their concerns should be taken seriously and they should be informed in an understandable and neutral way. For example, it would be negative if doctors tried to force unnecessary treatments on patients.

What is also important: Doctors should take the wishes of those affected seriously and react professionally if they want to get a second opinion before treatment or an intervention. Incidentally, patients have a right to inspect their medical records.

Since several specialists are usually involved in cancer treatment, those affected should know which practice has the main responsibility, who issues prescriptions for them, how the cooperation between different doctors and, if necessary, with a clinic is organized. According to the Cancer Information Service, it should also be clarified who needs which documents and how duplicate examinations can be avoided. Cancer patients must also be able to see who their contact person is in an emergency and who they can turn to with minor health problems such as a cold.

Organ Centers:

Are specialized in one type of tumor, e.g. breast cancer. Patients can be treated here on an outpatient and inpatient basis. It is usually a department of a hospital.

Oncology Centers:

These hospitals specialize in multiple types of cancer, so there are multiple organ centers.

Comprehensive Cancer Centers:

These are highly qualified, specialized centers with various inpatient departments and usually a central outpatient clinic. The CCCs conduct intensive cancer research and conduct numerous clinical studies. They also have a high level of expertise in rare cancers.

There are many hospitals in Germany that specialize in the treatment of cancer: university clinics, state hospitals, clinics run by church and private organizations. Clinics can have their range of treatments independently checked and certified. Most certifications are carried out in Germany on behalf of the German Cancer Society, as reported by the Cancer Information Service. The German Cancer Society offers an online search for specialized and certified clinics by region and type of tumor. Patients can find out here how the clinics got their certification. Those affected who want to be treated in a top oncology center can find more information about the centers on the network page.

Patients should also ask their treating physicians for support in choosing the right clinic. The Cancer Information Service also advises patients.

In the case of a serious illness and major surgery, it makes sense to get a second opinion. Patients do not question the expertise of a doctor. It is a legitimate practice to make an informed decision. This is also supported by the statutory health insurance companies. According to the consumer center, a third of the health insurance companies allow cancer patients to have a further assessment by specialists. Depending on the health insurance company, the procedure for obtaining a second opinion may differ. Some health insurance companies cooperate with online portals where the medical documents are submitted and checked. Other health insurance companies arrange appointments with specialists for their insured persons. Cancer patients should therefore ask their statutory health insurance company how they deal with second opinions for cancer patients.

Oncological top centers can also be a contact point for a second opinion. The Comprehensive Cancer Center of the Charité in Berlin, for example, offers a precision oncology consultation, during which the previous medical history is examined and patients are also advised on any further therapies. The treating physicians can also refer patients to such a top-level oncological center.

If you would like to get a second opinion from another team of doctors, you should bring all previous examination results, doctor's letters, X-rays, CT and MRT scans and laboratory results with you to this appointment. Patients receive these upon request from the treating physicians. Patients should inform the doctor treating them that a second opinion will be obtained before they decide on how to proceed. In principle, patients can obtain a second opinion at any time during their treatment.

Regardless of which therapy doctors suggest, it is just that: a suggestion. Patients have the final say on how and if they want to be treated. In later stages of cancer, therapies can sometimes only be life-prolonging and not life-saving. In addition to well-known cancer therapies, patients also have the option of being treated only palliatively. Pain and stressful symptoms are treated, but the cancer itself is no longer combated. Palliative care is used to maintain the best possible quality of life.

The state cancer societies offer medical, psychological and social counseling for those affected and their families. The consultation can be used throughout the course of the disease and is free of charge. A patient advice center can also be the contact point for questions about treatment, rehabilitation or patient rights.

It can be helpful for those affected to talk to other sufferers. You can find an overview of self-help groups at the Cancer Information Service. In Berlin there is a self-help organization for those affected and their relatives, which, in addition to information about cancer, also offers yoga courses and cooking events. Some offers are also available online. A psycho-oncological consultation can also help cancer patients to better cope with the psychological stress of a cancer diagnosis and illness.

Sources: Advice doctor/patient German Cancer Society, brochure cancer diseases from the cancer information service, German Cancer Aid Palliative Medicine, cancer therapies, personalized cancer medicine, University Hospital Augsburg second opinion, Charité second opinion, consumer center, RKI, medical center for quality in medicine, independent patient advice, German Cancer Society Psycho-oncology