I wanted to take a moment to share my experience in early dianosis and treatment/Dr. selection decitions for anyone that would benefit from this.

I was diagnosed last Thursday with low grade mucoepidermoidal carcinoma of the minor salivary glands. Found by acident, dentist noticed it, forwarded to oral surgeon who did the biopsy, and his lab did the analysis.

Oral surgeon's lab returned the diagnosis above and that oral surgeon had already made an appointment for me at the nearest ENT.

After I broke down in my car pulling out of the oral surgron's office, I dused myself off and went into that ENT's office to fill out the typical new patient paperwork to make the next day's appointment go fast and so I could beg for an earlier appointment because I knew the 24hrs until that appointment would be torture.

The first doctor I saw made me feel great... great prognosis, good chemistry with the guy, really felt better and like things would be fine.

Upon arrival at the second opinion, expecting a rubber stamp duplication from the original doctor, I was horrified to find that my 2nd opinion Dr. knew of an expert on this sort of surgery... and that this Dr. was in the same group as the man I had seen for a 1st opinion.

Why would he fail to tell me about this doctor? Speaking with the new doctor's nurse she mentioned that they get about 90% of the group's cases but every once in a while, some ENTs in the group want to do the procedure themselves.

Moral of the story... the second opinion idea is not lip service and the presentation of a need for one isn't as obvious as one would think (bad chemistry with the Dr., perceived inexperience, etc weren't a factor here, we felt great with the guy).

Because of that I'm hitting my 3rd opinion Monday... not to make my head spin but as the best fact-finding I can do to ask around who's done these procedures the most.

Stephen:

That really stinks!!!!!

You are fortunate being able to get into see so many ENT's so quickly. Good luck with the 3rd ENT.


Christine

Thanks! I'm trying to be more aggressive than my tumor!

Stephen,
I know your head is a little full right now so I'll be brief. Second, third and fourth opinions can be beneficial but, disappointing. From what I read (I read it four times before writing this so I wouldn't miss anything...yeah I got a lil ADD) I think I may have a little bit of good news for you.
You wrote, "... and that this Dr. was in the same group as the man I had seen for a 1st opinion."
It is quite possible that your first opinion consults with his group member, trained under him and or evaluates cases with him.
If I were in your position I would see the 3rd guy and in fact ask him these questions as well as the million other questions I'm sure you have. You already said you and the first doctor meshed well and he made you feel good.
Didi your second opinion doctor provide you with any clinical information that was different from the first? I know at times when someone states that someone is an "expert" or specializes in something we automatically think we were mislead and nee to see them.
The advantage to groups of doctors practicing together is that often times multiple opinions and experiences are given on biopsy results and posiible treatment plans by other members of the group. I was in a group practice for eight years and we routinely consulted each other for advice, expertise and opinion on patients and many of my medical colleagues in group practices do the same. This may or may not be the case with you but, it is worth asking the questions.
Please contact me if I can help or answer any questions.
My thoughts and prayers are with you.
Cheers,
Mike

Dr. Mike,

Thank you so much for the time and thoughtful post.

The terminator, as I like to call the third Dr., offered a little different view of the CAT scan films in that he focused on the fuzzier image of the bone near the tumor.

I think the biggest benefit I see from the terminator doing the procedure is that he seems to have much more experience in it given that he just did one last month... that same statement/confidence was absent from the first Dr when I questioned him on how many times he'd done the procedure he was proposing.

However, I'm sure the truth of the matter on whether the first Dr. was going to consult within his group and especially with this specialist is much less sinister than I may have portrayed so in the original post.

My wife and I are very confident in the terminator, though the first Dr. was a funny and personable doctor... the perceived experience by the terminator based off of what he told us on his experience, write-up of his bio, and other details vs. the first guy actually makes us feel better than with the first guy at this point.

I'm glad to read you're a 10 year cancer survivor comes as a good re-assurance with the recent high profile celebreties' passing (Tony Snow, Randy Pauch from the last lecture).

I know every patient, cancer, and so forth is different and I'm not properly crediting the number of people on this thread and elsewhere that have also been cancer free for a number of years, but I'm new at this and still trying to keep my mind out of those counter-productive thought processes it likes to go into.

Thanks,

Stephen

Stephen, as Dr. Mike pointed out, this second and third opinion thing can get more confusing than helpful at times. We also need to examine our motives when seeking second and third opinions -- are we looking for the best answer, or the answer we find most palatable? Those are often two different things.

In my case, the biopsy was done by my usual ENT (who somehow missed the cancer during my regular appointment -- discovered by anesthesiologist in unrelated surgery), but when diagnosis came back as malignant, I went straight to James Cancer Center. They told me that my best shot for survival was very aggressive treatment regimen, so I went with it. I could have shopped opinions around that perhaps would have suggested less aggressive treatment, which would have been appealing, but would it have been as effective?

We need all the information we can get, but we ultimately still need an objective way of evaluating the differences. I am no oncologist, so I went to one of the best facilities in the country, and figured that if they did not know how to do it, it probably couldn't be done. ;-)

Good luck and keep posting here!

Thanks Jeff, that's excellent advice. I can see where the 2nd, 3rd, and successive opinions could be confusing or convenient for someone shopping for what they want to hear.

In my case, the second opinion (really third since the 2nd doctor immedietly sent me to the terminator) was a more aggressive treatment aimed at taking advantage of this early stage of the cancer and eliminating it hopefully once and for all.

Another point you bring up though is that of going go a cancer center rather than an ENT office or practice only... you've got me thinking that maybe I need to seek out a cancer center for potentially yet another opinion.

I'm not seeking lesser of a treatment, and have learned that the most aggressive is not always the smartest selection, but at least trying to have a whole host of options to choose from.

Thanks,

Stephen