Second opinions matter
A recent, personal experience taught me an extremely valuable lesson: Medical patients faced with devastating diagnoses should not take them at face value, but should get a second opinion before changing their wills or charging off for surgery or chemotherapy.
My journey started Dec. 1, 2011, when I went to the emergency room with severe abdominal pain. The triage nurse immediately suspected kidney stones, a diagnosis confirmed by a CT scan later that morning.
The radiologist reading the scan also reported that a "mass" on my liver was "suspicious for cancer." Further diagnostics regarding the tumor were delayed, however, because a large kidney stone had to be dissolved though a surgical procedure, and it took more time for additional stones to pass.
In the meantime, I was distraught. What was a tumor the size of a walnut doing sitting on my liver? Where had it come from? Was it malignant or benign? Would someone please tell me?!
Finally, I was able to have a liver biopsy Jan. 6. Unfortunately, when the pathology lab's written report came out Jan. 10, it concluded the tumor was malignant. The implied diagnosis for patients with this type of cancer (hepatocellular carcinoma): death within six months.
My general practitioner immediately set up an appointment with a local surgeon who was ready to operate, and the surgeon set up an appointment with an oncologist to plan a course of chemotherapy after the surgery.
My wife and I were absolutely stunned. I was entirely symptom-free, and a laboratory analysis of my blood confirmed that I had no cirrhosis, hepatitis or other liver disease. The diagnosis made no sense. We spent several days reading everything we could find online about liver tumors and concluded that the diagnosis was likely erroneous. Why? Because the typical patient with such a diagnosis already has serious liver disease.
I didn't know a neoplasm from an adenoma, but I knew this: I wasn't sick, and the pathology report was far from definitive. At the very least, I had to get a second opinion before going under the knife.
I knew from our research that UCLA has a nationally renowned liver-research and -surgical center. So when I met with the local surgeon, I told him I had reservations about the diagnosis and asked if he would be offended if I requested a second opinion.
Far from it. He quickly agreed and even volunteered to arrange for the slides from my biopsy to be sent to UCLA's pathology laboratory for review. It was three agonizing weeks before we received their report, but the news was good: The tumor was benign!
I also was offered the opportunity to consult with UCLA's No. 1 liver surgeon, the doctor who started UCLA's liver-transplant program and who apparently had taken an interest in my case. Of course, I said yes, and my wife and I traveled to Los Angeles and met with him, a senior fellow studying transplant surgery and two residents. The doctor strongly recommended removing the tumor, even though it was benign, because it was large, could rupture and bleed or grow and damage my liver or other organs.
We accepted his recommendation, and I had the tumor removed at UCLA. There were no complications, and I am well on the road to recovery. And there is no "course of chemotherapy" on my schedule.
So the episode has a happy ending, but only because I was proactive, did my own research and didn't take the fatal diagnosis lying down. You shouldn't either.
Dennis Kendig and his wife, Margaret Daugherty, live in Ashland.