Hi Gabe,

Your question below is an honest question that many cancer patients grapple 
with.  I often start my consultation with my patients, "Even with all our 
knowledge and advances in medicine, there are basically only three approaches 
to get rid of cancer - surgery, radiation therapy and systemic (chemo) therapy."

In the past we used to use only one of these options (mono-therapy) in any 
given patient.  Now we realize that each of these options have their strengths 
and their LIMITATIONS.  Hence the current approach is to use a combination of 
these options. Thus one treatment compensates for the limitation of the other.  
And each treatment does not have to be too aggressive. Using this, team 
approach, we can get as good as or better results with LESS side-effects.

The "bottom line" is the patient does not know which is the best approach to 
their cancer and how to sequence the combination.  This information can only be 
obtained by the patient getting a 'second opinion' from another specialist.  As 
we say a 'Ford car dealer' (even if he is your brother-in-law) is not going to 
recommend a Toyota car. The customer has to check it out for themselves.  

When the patient seeks a second opinion, that gives the "second" doctor the 
right and the duty to dialogue with the first doctor about the nuances of the 
patient's cancer and suggest a best approach for that individual's cancer.  A 
good doctor never objects to a 'second' opinion.  I say to my patients,"by all 
means do so. If the other doctor agrees with me, you will have even more trust 
and confidence in me instead of constantly second guessing me.  If the other 
doctor suggest something different, that is an alternative for the patient to 
consider."  By the same token nothing helps me better manage my informed 
patient, than one who is at peace and concentrates to help themselves.  Second 
opinions are good for any major treatment, not only for cancer.

Kind Regards, GL

---------- Gabe Menezes 

I believe the bottom line, is this - would one rather have invasive surgery or 
do not, when afflicted with Cancer; is chemotherapy and radio treatment the 
only options ?
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