Second Opinion for Leukemia

A friend of mine, Amy was recently diagnosed with Leukemia. Her health was deteriorating and she was eventually admitted to a hospital. Amy’s primary doctor started her on an intensive chemotherapy regimen. But, the results were unsatisfactory. She was dejected and felt lost. So, when her primary doctor told her that a second chemotherapy regime was the only hope left, she pondered that maybe it was time to explore other options.

Amy decided to get a second opinion from another doctor who had expertise in treating Leukemia. The specialist believed that she could benefit from a bone marrow transplant. After careful consideration, she decided to give it a go. Amy’s health has improved significantly and the last time I met her, she looked happy and healthy.

Unlike Amy, not everyone is comfortable with seeking a second opinion. We feel that we are betraying our primary physician by consulting another specialist. However, a second opinion can be instrumental in obtaining more information about your condition and treatment options.

Stories of people like Amy never fail to emphasize the significance of obtaining a second opinion. By being educated about your disease, its prognosis, and treatment, you become an informed patient. This will enable you to make the best healthcare decisions.

Here, I have addressed some of the common concerns surrounding Leukemia and a second opinion for it.

Misdiagnosing Leukemia

Leukemia starts in the bone marrow when blood cells begin to grow abnormally. These abnormal blood cells, usually white blood cells (WBCs) do not function properly and enter the bloodstream. From here, they spread throughout the body.

Some of the symptoms of Leukemia are:

• Fever
• Fatigue
• Frequent infections
• Weight loss
• Easy and unexplainable bruising or bleeding
• Night sweats
• Bone pain
• Swollen lymph nodes

If not Leukemia, then what could it be?

Diagnosing Leukemia is complicated by the fact that its symptoms can be similar to other diseases. This often leads to high rates of misdiagnosis that can have severe and long-lasting consequences.
Several diseases could be misdiagnosed as Leukemia. Some of these include:

• Immune thrombocytopenic purpura: This blood disorder occurs when the immune system begins to attack your platelets leading to reduced platelet count in the body. It can lead to symptoms like bleeding gums, easy bleeding, and bruising. This condition can be mislabeled as Leukemia.
• Amyloidosis:  Amyloidosis occurs because of the accumulation of amyloid protein. Though it may be associated with blood cancers, it is not cancer itself. Its symptoms include fatigue, swelling, shortness of breath,  bleeding, and bruising.
• Bleeding disorders: These disorders are characterized by excessive bleeding because of impairment of the blood clotting process in the body.

Reasons to obtain a Second Opinion for Leukemia

A Leukemia diagnosis can be quite unnerving for many people. As you saw in Amy’s case, you don’t have to stick to your primary doctor. Instead,  a second opinion from a hemato-oncologist who specializes in Leukemia care can guide you in the right direction for your treatment. There are several reasons why you should consider a second opinion for Leukemia. Some of these are given below:

• Diagnosing leukemia can be difficult: Given the number of subtypes leukemia has, correctly diagnosing it can be tricky. Leukemia has more than 10 types, each with its characteristics and specific treatment. Your doctor may have diagnosed you with Leukemia, but it is a possibility worth considering that the diagnosis may be incorrect. By getting a second opinion, you can protect yourself from the ramifications of misdiagnosis.
• Current treatment is not working: In case you are dissatisfied with your ongoing treatment, it may be time to get in touch for a second opinion with hemato-oncologists. Consultation with them can expose you to alternative treatments for Leukemia.  These treatments may be more beneficial in controlling your symptoms.
• Recommended treatment is invasive/risky: Your primary doctor will advise you on some treatments based on his knowledge and experience. Some of these can be invasive and may make you uneasy. You must realize that you have the right to choose treatments based on your comfort. By connecting with the board of hemato-oncologists, you can receive suggestions on novel and up-to-date treatments that may be less invasive.
• Lack of knowledge about Leukemia: When you consult your primary physician, you may simply receive a diagnosis based on your symptoms. But, by getting a second opinion from certified hemato-oncologists who have treated several Leukemia patients, you can understand your condition in-depth. This allows you to make educated decisions about your health.

Cost of Second Opinion for Leukemia

Finding the Right Treatment for Leukemia

Most treatments for Leukemia will focus on eliminating the cancerous cells or slowing their growth. You must know about different types of  Leukemia treatments so that you can choose the most suitable one for yourself. A second opinion from a highly-skilled and qualified hemato-oncologist can empower you to choose the best treatment. Some of the commonly recommended Leukemia treatments are

• Chemotherapy: A chemotherapy regimen for Leukemia comprises a cocktail of drugs. These either kill the cancerous cells or reduce their growth. Since each drug has a different mechanism of action, a combination of drugs can make the cancerous cells more susceptible to treatment.
• Bone Marrow Transplantation: This method has been used successfully to treat acute myeloid leukemia. It involves transfusing the patient with healthy stem cells either from a donor(allogenic) or the patient’s body(autogenic).
• Targeted therapy: This therapeutic method uses drugs that specifically target the abnormalities found in cancer cells to destroy them. Thus, overriding the toxic effects of drugs on normal cells.
• Radiation Therapy: Radiation therapy employs high doses of X-rays to kill the tumor cells. You may be given radiation in a particular region of the body where leukemia cells are concentrated or over your entire body.
• Immunotherapy:  Cancer cells produce proteins that prevent them from being identified by the immune system. Immunotherapy uses drugs that make Leukemia cells discoverable. Thus, allowing the immune system to recognize and kill tumor cells.

Choosing a Second Opinion with MediGence

A Second Opinion for Leukemia can play a key role in reassuring you about your diagnosis and treatment choice.  There are many advantages of availing a second opinion on MediGence’s Second opinion platform. These include

• Board of specialists: For a second opinion, you will be connected to the hematology board consisting of well-trained hemato-oncologists and hematologists.  They will review your case in detail and combine their views on your treatment in a single written report.
• Second opinion report on time: Time is critical in serious illnesses like Leukemia. MediGence understands this and delivers your second opinion report swiftly within 5 days. This can help you in making a fast yet informed decision about your treatment.
• Intelligent clinical workbench: MediGence uses a proprietary technology that allows you to provide information about your symptoms, diagnostic tests, and treatments conveniently. You can easily upload the results of imaging tests as DICOM files on the MediGence second opinion platform.

Preparing for your Second Opinion

A Second Opinion is a valuable opportunity to resolve your concerns. You need to be well-prepared to obtain a legitimate and useful second opinion for your leukemia diagnosis and treatment. The following steps can help you get the most out of your second opinion consultation.

1. Make a list of questions you want to ask

Asking the right questions will help clear your doubts about leukemia diagnosis, treatments, and prognosis. Some of the questions you can ask your doctor for Leukemia treatment are:

• Have I been diagnosed with the correct condition?
• Is the recommended treatment the most ideal for me?
• If not, what are some other treatment options I can pursue?
• Are the alternative treatments affordable? If so, are they available in my country? If unavailable, which country offers that treatment?
• What will be the duration of my treatment? How long do I have to stay in the hospital?
• What is the success rate of my treatment?
• Is Leukemia curable?
• Do I need immediate treatment or can I wait for some time?

2. Assemble your Medical records

The team of board-certified hemato-oncologists will need a detailed record of your medical history, your symptoms, the diagnostic tests you have participated in, their results, and information about any treatment you have been receiving for Leukemia.
You should arrange the following documents and review them before uploading them on MediGence’s second opinion platform:

• Blood test results: A complete blood count (CBC ) test is often used to diagnose Leukemia. It measures the quality and quantity of different types of blood cells such as white blood cells, red blood cells, and platelets. An increased number of immature blood cells in your CBC report could indicate Leukemia.
  Besides CBC, your primary physician may also order some blood chemistry tests to detect certain chemicals in the blood. These chemicals indicate the health of your liver and kidney that may have been affected by cancer.  Thus, helping in staging Leukemia.
• Bone marrow biopsy report: During this process, the bone marrow is aspirated to collect cells for testing. The sample is then checked for the presence of Leukemia cells. Thus, a bone marrow biopsy report can confirm Leukemia.
• Imaging Test results: Imaging tests like chest X-rays, CT scans, and MRI can provide useful information to the hemato-oncology team. These can be used to determine if Leukemia has spread to the brain, chest, or liver.
• Lymph Node Biopsy report: In this test, a small part of the lymph node is excised and studied under the microscope. The pathologist views this tissue sample and ascertains if there are any cancer cells in the tissue. Thus, helping in confirming the presence of Leukemia.

What to do if your second opinion differs from the ongoing/proposed line of treatment?

The Second Opinion doctors may have a different stance regarding your recommended or current treatment. This may lead to confusion and uncertainty about your health. But, you need not worry as MediGence can assist you in the following ways:

• The Second opinion team of hemato-oncologists will suggest more suitable alternatives for you.
• The lead doctor from the board of hemato-oncologists can also explain the second opinion report via a telemedicine session if you wish so.
• After analyzing the pros and cons of different alternatives, you can choose the best treatment as convenient for you.
• You can pursue the chosen treatment in your country or another country of your choice.
• If you wish to travel abroad for your treatment, MediGence can assist you in finding the hospital and hemato-oncologist at the destination of your choice.

Facts about Leukemia

• Leukemia can be divided into major types: acute myeloid leukemia(AML), chronic myeloid leukemia (CML), chronic lymphocytic leukemia(CLL), and acute lymphoblastic leukemia(ALL).
• Acute Leukemia progresses rapidly whereas chronic leukemia progresses slowly.
• Leukemia can occur in people of any age group. But, it is more prevalent in adults above 60 years of age.
• The Philadelphia chromosome is a marker for chronic myeloid leukemia.
• The exact cause of Leukemia is unknown.

Reference Links:

• Leukaemia.org
• My.clevelandclinic.org
• lls.org