Analysis of motives and patient satisfaction in oncological second opinions provided by a certified university breast and gynecological cancer center

Christian R Loehberg,Sonja Wasner,Paul Gass,Carolin C Hack,Alexander Hein,Sebastian Jud,Peter A Fasching,Michael P Lux,Julius Emons,Yesim Erim,Jessica Krebs,Sainab Egloffstein,Julia Meyer,Marius Wunderle,Matthias W Beckmann,Lothar Häberle

doi:10.1007/s00404-020-05525-2

Christian R Loehberg, Sonja Wasner + Show 14 more

Open Access

https://doi.org/10.1007/s00404-020-05525-2

Copy DOI

Abstract

PurposeSecond opinions in oncology are becoming increasingly important in an era of more complex treatments and a growing demand for information by patients. Therefore, we analyzed their effects and influencing factors like patients’ motives, subjective extent of information and satisfaction with communications.MethodsThis prospective study evaluated second opinions for patients with breast cancer or gynecological malignancy. The patients received a questionnaire before and two months after, which inquired expectations, reasons, and satisfaction with the second opinion and the attending physicians.ResultsA total of 164 patients were included and the majority had breast cancer (75.0%). Receiving the second opinion made 89.7% feel better informed, their need for information decreased (from 75.3% to 39.2%, P < 0.0001), and satisfaction with doctor–patient communications increased (from 61.9 to 91.8%, P = 0.0002). There were various reasons for requesting a second opinion, e.g., the extremely stressful situation of a cancer diagnosis, hope for change in the treatment recommendation or dissatisfaction with the initial physicians.ConclusionsSecond opinions can lead to significantly greater patient satisfaction, meeting the need for information and leading to better management of patients in the extremely stressful situation of a cancer diagnosis. Doctor–patient communications play a key role.

Highlights

An initial diagnosis of cancer leads many patients to carry out careful research on the diagnosis and the best treatment approach for it
Patients with breast cancer or a gynecological malignancy could either present directly for a second opinion during the special consultation hours in the Department of Gynecology at Erlangen University Hospital, or they could request a second opinion by phone through the “CCC Erlangen–EMN Cancer Information” service at Erlangen University Hospital, which subsequently arranged for presentation of the case at the relevant interdisciplinary tumor conference
The analysis examined whether there were any age differences in relation to motives for requesting an oncological second opinion

Summary

Introduction

An initial diagnosis of cancer leads many patients to carry out careful research on the diagnosis and the best treatment approach for it. In a large number of cases, patients only turn to a certified organ cancer center or oncology. Adequate interdisciplinary consultation and care within the structures provided by certified centers would already be advisable at the time of the initial diagnosis [1]. The establishment of oncological centers and certification procedures conducted by the German Cancer Society V., DKG) is promoting optimization of the quality of care for patients diagnosed with cancer and is encouraging interdisciplinary collaboration [2].

Methods

Results

Discussion

Conclusion