Sizing Up Surgery
Thousands of Americans face surgery each year, often with fear and doubts
about whether the right step is being taken. And not knowing what's involved
may mean putting yourself through as much grief as the procedure intends to do
away with. Whether you are undergoing surgery for the first time or the tenth,
understanding why you need it, the risks involved, available alternative
treatments, and the aftereffects will help you make the right decisions and
deal effectively with the outcome.
The Value of a Second Opinion -- Is Surgery Necessary?
The practice of medicine is not an exact
science and, consequently, physicians do not always agree. This does not mean
they are incompetent or unconcerned about their patients' well-being. It simply
means there can be differences of opinion about the best way to treat a medical
condition. A second opinion is a time-honored practice in the medical
profession that public health authorities believe better enables people to
weigh the benefits and risks of surgery against possible alternatives to
In the case of a middle-aged patient with
gallstones, for example, Betsy Ballard, M.D., a surgeon in Silver Spring, MD,
explains that the initial recommendation for surgery might be made based on the
premise that someone that age would not be satisfied with spending remaining
years on the strict diet needed to manage the disease. There also might be the
danger of a recurrence or complications, such as pancreatitis, if the dietary
restrictions did not successfully treat the disease. A second opinion, however,
might reveal that the patient for whom surgery poses a risk or who refuses
surgery would be a candidate for medicines or other procedures that can
dissolve gallstones. In either case, a second opinion helps the patient make an
informed decision about the best treatment for his or her condition.
Arno Albert Roscher, M.D., a clinical
professor of pathology who specializes in diagnosing cancer at the Granada
Hills Community Hospital in California, says that, like patients, health
professionals often find it necessary to seek additional viewpoints as well.
For example, some forms of cancer pose controversy for even the most skilled
professionals in the field.
"A certified pathologist can generally
identify 85 percent of regular tumors," Roscher says, "but if there is
a glandular difference, tumors are difficult to diagnose and often require
second and sometimes third opinions." He adds that even with the small
number of unrecognizable tissue growths, specialists need the availability of
additional resources to confirm or dispute their findings and recommendations,
such as through the California Tumor Tissue Registry, a network of qualified
professionals that was created for such specialized second opinions.
There are, however, instances when emergency
surgery is necessary in order to sustain life, such as when the diagnosis of
acute appendicitis is firmly made. In this case, surgery must be done quickly
and efficiently, and would not warrant a second opinion.