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Getting a second opinion

Should You Get a — Second Opinion Before Starting Treatment?

Most people feel uncomfortable asking for a second opinion. They worry it will upset their oncologist, delay their start date, or seem like distrust. In most cases it does none of those things — and a review often changes something.

Medically reviewed by Dr. T. Raghavender Reddy, Medical Oncologist, MBBS · DM (Medical Oncology) · MD (Radiation Oncology) · Last reviewed September 2026

  • It is expected, not offensive — Oncologists following ASCO and ESMO guidance expect patients to seek a review. Most will help you gather the documents.
  • Delay is usually a few days — For most solid tumours, a short pause before starting does not change what treatment can do. A true emergency is the exception, and your team will tell you clearly if that applies.
  • A review often changes something — A second opinion can change the diagnosis, the treatment approach, or both. The proportion is higher than most people expect.
  • You need your records anyway — Gathering documents for a second opinion also gives you your own copies for ongoing care — something every patient should have.
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A second opinion before starting treatment is almost always worth the few days it takes. ASCO guidance notes that a review can change the diagnosis or the treatment plan in a meaningful proportion of cases. To get one, send your pathology slides, imaging reports and current treatment plan to a second oncologist.

When does a second opinion matter most?

Your situationUsually fine to proceed with one opinionWorth getting a second opinion first
Cancer typeCommon cancer with established, clear guidelinesRare cancer, unusual subtype, or a diagnosis that surprised your team
Pathology reportClear and consistent findingsComplex, borderline, or conflicting with what the imaging showed
Treatment optionsOne clearly recommended pathTwo or more options with real trade-offs that you have to weigh
Your confidenceYou understand the plan and feel settledYou are uncertain, or feel the decision is being rushed
Treatment urgencyWeeks before first treatment is medically standardA true oncologic emergency — your team will tell you this explicitly and act on it the same day

What do you need to send for a second opinion?

  • Your pathology report and the original biopsy slides or tissue blocks — not just a printed copy of the report
  • All imaging: CT, MRI, and PET-CT reports and the images themselves on a CD or digital transfer
  • Blood test results, including any tumour marker tests that have been done
  • The treatment plan your oncologist has recommended and the reasoning behind it
  • A list of all medications and supplements you are currently taking
  • Your current oncologist's name and contact details, in case the reviewing team has questions

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Send your reports across and a specialist will walk you through what they mean — what is known, what is not, and what the options actually are.

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Dr. Naresh Gundu
Medical Oncologist

Dr. Naresh Gundu

MBBS, DNB (Internal Medicine), DM (Medical Oncology)

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Dr. C. Raghavendra Reddy
Medical Oncologist

Dr. C. Raghavendra Reddy

MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)

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Dr. Bharati Devi Gorantla
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Dr. Bharati Devi Gorantla

MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)

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Dr. Owais Mohammed
Medical Oncologist

Dr. Owais Mohammed

MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)

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Dr. T. Raghavender Reddy
Medical Oncologist

Dr. T. Raghavender Reddy

MBBS, DM (Medical Oncology), MD (Radiation Oncology)

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Dr. N. Kiranmayee
Medical Oncologist

Dr. N. Kiranmayee

MBBS, DM (Medical Oncology), MD (Internal Medicine)

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Dr. Muralidhar Muddusetty
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Dr. Muralidhar Muddusetty

MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)

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Dr. Raghavendra Naik
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Dr. Raghavendra Naik

MBBS, MS (General Surgery), M.Ch (Surgical Oncology)

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Dr. Mohammed  Imaduddin
Surgical Oncologist

Dr. Mohammed Imaduddin

M.B.B.S, MS (General Surgery), M.Ch (Surgical Oncology)

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Dr. Vinay Mamidala
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Dr. Vinay Mamidala

MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)

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Dr. Paila Gowri Naidu
Surgical Oncologist

Dr. Paila Gowri Naidu

MBBS, MS (General Surgery), M.Ch (Surgical Oncology), FMAS

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Dr. Venkata Sushma P
Radiation Oncologist

Dr. Venkata Sushma P

MBBS, MD (Radiation Oncology)

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Dr. Kirti Ranjan Mohanty
Radiation Oncologist

Dr. Kirti Ranjan Mohanty

MBBS, MD (Radiation Oncology)

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Hematologist

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MBBS, M.D (Immunohematology & Blood Transfusion)

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Interventional Radiologist

Dr. Mohammed Imran

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Dr. Vajja Sandeep Kumar
Surgical Oncologist

Dr. Vajja Sandeep Kumar

MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology

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Surgical Oncologist

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MBBS, MS (General Surgery), DrNB (Surgical Oncology)

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How do you get a second opinion, step by step?

  1. Tell your treating oncologist

    Let your oncologist know you want a second opinion before deciding. Most expect this and will help you gather the records. A team confident in their plan is not troubled by a review.

  2. Request all your records

    Ask for your pathology slides or tissue blocks, imaging on disc or digital transfer, written reports, and blood results. You are entitled to these, and hospitals are required to release them to you.

  3. Contact the reviewing centre and send the documents

    Ask the reviewing centre what format they need and how long the review will take. Digital pathology transfer is now common and can avoid delays caused by physically moving tissue blocks.

  4. Attend the review appointment

    This may be in person or by video call. Bring a family member if you can — two people retain more from these conversations than one person does alone.

  5. Bring both opinions back to your team

    If both opinions agree, that gives you confidence to proceed. If they differ, ask each oncologist to explain their reasoning, and consider a third specialist review if the difference is significant.

Will getting a second opinion delay your treatment dangerously?

For most newly diagnosed solid tumours, ASCO and ESMO acknowledge that a short review window of a few days to a week is medically reasonable before committing to a major treatment plan.

The cancers where speed is a genuine emergency — certain blood cancers, spinal cord compression, blocked airways — are ones your oncologist will name explicitly and manage urgently. In those situations, an urgent second opinion at a specialist centre is still possible, and your team can help arrange it.

The risk that concerns oncologists more than a short delay is starting on a plan that a review would have changed.

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Common questions

Frequently asked questions

Will my oncologist be upset if I ask for a second opinion?

Most oncologists trained in evidence-based practice expect patients to seek a review before a major treatment decision, and ASCO explicitly supports this as part of informed decision-making. If your team is confident in their plan, a review will confirm it — and that is a good outcome for everyone. A team that discourages you from getting one, or makes it difficult to access your own records, is worth noting.

How long does a second opinion usually take?

Most second opinions for newly diagnosed solid tumours take three to ten working days, depending on whether the reviewing centre needs the original tissue blocks or can work from digital slides and reports. Some specialist centres offer faster turnarounds for urgent cases. When you first contact the reviewing centre, ask for a timeline so you are not waiting without a clear date to plan around.

What if the two opinions are different?

A difference of opinion is more common than most people expect, and it is not a reason to panic. The difference may be small — a different drug sequence or surgical approach — or occasionally more significant. When opinions differ, bring both back to each oncologist and ask them to explain their reasoning. If you are still unsure, a third review at a centre with specific expertise in your cancer type is a reasonable next step.

Do I need to travel to another city?

Not necessarily. Many specialist centres now accept digital pathology slides and imaging files and conduct the consultation by video call. Ask any centre you approach whether they offer remote review. If your cancer is rare enough to need a specialist centre that is far away, your current oncologist can help you make contact and arrange the transfer of documents.

Can CION provide a second opinion for a diagnosis made elsewhere?

Yes. CION oncologists review cases for patients diagnosed at other centres. Bring your pathology report, biopsy slides, imaging and any existing treatment plan to the consultation. If you are already a CION patient and want an external review, your team can help you identify what to send and how to request your records.

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