There does not have to be a referral to get a second opinion, but he must get there with all his medical records and scans, and insurance or money to have the referral. This is certainly true at MDACC and many others. There should be no reason for any quality doctor to not want to get a second opinion of his patient's situation unless he fears that he hasn't behaved in accordance with accepted standards of practice. Delays, especially in cases that are not responding well, are completely unacceptable. Get on the phone and make lots of noise.
Most docs welcome confirmation that they are on the right track or obtaining a new idea if theirs is not working.
As to commenting on treatments, there must be some misunderstanding about what the surgeon is considering doing.... going through the groin for an oral cancer seems like a long way around things if you get my drift.
Lastly, no matter what the stage of a patient's disease there is no reason for him to be dealing with pain. Pain management is the most basic right of any patient in treatment, and doctors can prescribe additional or alternative medications to bring this under control. This is again something that you should get on the phone to the doctor about and DEMAND that something definitive be done immediately to control the discomfort.
A discussion of the situation with the doctor to get his prognosis is important. Given the rate that this is moving and the lack of response, I would want to know where things were going, and what his impressions are about the future.
