Second opinion

Hi, I have been diagnosed with clear cell renal cancer, the tumour is 11cm. In December they were unable to remove the kidney as the tumour is also invading the liver. 
Biopsy result was non diagnostic the first time, the second time in January the biopsy was successful and has come back as CCRC.

I have seen the Oncologist who is proposing starting me on immunotherapy in 3 weeks time at Southend Hospital. The combination is Nivolumab and Ipilimumab.

I asked for a second opinion weeks ago and was told the referral would be done on once the biopsy result was through. That was 10 days ago, the second opinion is about treatment and the way forward. However the referral to the Marsden was not done, and is only being referred now. This has caused a 9 day delay. The referral is unlikely to come through before my treatment at Southend begins. 

I’m unsure whether to delay my Southend treatment and wait until the Marsden can assess my case. I’m showing no other symptoms a yet.

I’m unsure if the Marsden can offer anything different or potentially more successful than Southend are offering.  

  • Hi ,

    Thanks for getting in touch with us at what sounds like a difficult time for you just now.

    Making treatment decisions can be overwhelming, and worrying about delaying treatment can increase anxiety levels

    Decisions about treatment are made by a group of experts (MDT).

    Your drug treatments for kidney cancer will be based on the stage and grade of your cancer and your general health.

    Some people do ask for a second opinion if they are unsure that they are being offered the right treatment. They may also want to see if there is a different treatment available. Waiting for a second opinion can cause delays to starting treatment. And the treatment offered may be the same as the first opinion.

    But only you can decide whether you are happy to wait and see if the Royal Marsden will offer you anything different. The most important thing is that you feel comfortable with the decision that you make.

    It is an idea to contact your current team at Southend to ask if the referral has definitely been sent.

    This information from the Royal Marsden Hospital states

    Due to the high number of second opinion requests The Royal Marsden receives, they are not able to accept all referrals for a second opinion.

    However, where the referral is accepted, a clinician will review the request and will either provide a written second opinion for the referring doctor. Or they may see the patient for an assessment if The Royal Marsden can offer a different or specialist treatment or entry into a clinical trial.”

    It can be helpful to contact the Royal Marsden direct who may be able to give you a rough estimate of how long you should expect wait to hear back from them.

    You can also ask your current team if delaying starting your current recommended treatment could be detrimental in your situation. This is important before making the final decision about what you feel will be the right option for you.

    There are many ways that we can offer you support. I can see that you’ve already joined our kidney cancer group. That’s great to see as there nothing quite like the support that you can get from others who know what it’s like.

    You can also give our Support Line a call on 0808-808-0000. Our lines are open every day from 8am till 8pm.

    Best wishes and take care.

    Ellen-Macmillan Online Digital Nurse