Second Opinions for Childhood Serious Illnesses: What to Know
Talking with more than one physician can help families feel confident in decisions about their child’s care.
When a child is diagnosed with a serious illness, families face many decisions. One important question is: “Should we get a second opinion?”
The answer is often “yes,” when it is safe and treatment is not needed right away.
A second opinion can help confirm the diagnosis, offer treatment options, and give families peace of mind.
Why a second opinion matters
A second opinion means asking another qualified health care provider to review your child’s case. It can help to:
- Confirm the diagnosis
- Learn about other treatment options
- Find experts for rare conditions
- Explore clinical trials if treatment is not working
Kayla Foster, MD, assistant professor at Baylor College of Medicine.
When to seek a second opinion
According to Kayla Foster, MD, assistant professor at Baylor College of Medicine, families often seek a second opinion at these times:
1. At diagnosis
If the diagnosis is unclear or families want confirmation before starting treatment (unless treatment is needed right away).
2. When there are multiple treatment options
Some illnesses have more than one accepted treatment plan. Cure rates may be similar, but side effects and long-term impacts can differ.
“An example in pediatrics is Hodgkin lymphoma,” Foster says. “There are a few options for treatment with a good chance of cure. But each treatment comes with different side effects that should be considered when making a plan.”
3. If treatment is not working
When the first plan does not work, a second opinion can open doors to new options or clinical trials.
“If treatment is not going as expected,” Foster says, “a second or third opinion from another institution might offer options for a clinical trial for a disease that might not otherwise have great options.”
Other reasons to seek a second opinion might include:
- Feeling unsure about the diagnosis, stage, or type of disease
- Having trouble communicating with your health care provider
- Wanting peace of mind
Check with your insurance company to see what they will cover before getting a second opinion. Some U.S. states have laws that give you the right to a second medical opinion covered by your insurance company.
Alberto Pappo, MD, co-leader of the Developmental Biology & Solid Tumor Program at St. Jude Children's Research Hospital.
How to get a second opinion
Alberto Pappo, MD, an oncologist at St. Jude Children’s Research Hospital, suggests that you ask yourself, “Can my doctor provide the best and highest level of care for my child’s condition?“
Be honest with your current provider. Most of them support second opinions. You can say, “We would like to make sure we are on the right track. Would a second opinion help?”
If your child has cancer, a genetic disease, a blood disorder, or another serious condition, you can ask:
- “Is this a common or rare condition?”
- “Who are the experts in this area?”
- “Should another specialist review this case?”
Your health care provider may share the case with a team of experts to help make sure the diagnosis and treatment plan are correct. Such teams include:
- Tumor boards (for cancer)
- Genetics boards (for genetic or metabolic diseases)
- Hematology boards (for blood disorders)
- Case conferences, where specialists from different fields review the case together
Other times, you may contact another hospital directly.
Some major centers have referral numbers online and offer second opinions at no cost.
“At St. Jude, we are more than happy to contact your primary physician, obtain records, and give our opinions,” Pappo says. “When in doubt, reach out.”
What to bring
When seeking a second opinion, bring or have your primary care team send as much information as possible. This may include:
- Imaging (x-rays, MRIs, CT scans)
- Lab results
- Pathology reports
- Genetic test results
- Treatment records
- Operating room report if your child had surgery
- Bone marrow aspirate and biopsy slides (not just the report)
- Hospital discharge summaries
- A list of current and past medicines
- A list of questions to ask
You can ask for copies of your records from your current provider. They may also be able to send your records directly to the new specialist.
Will a second opinion delay treatment?
Sometimes, yes—especially if you seek a second opinion right after diagnosis. Ask your provider if waiting is safe. In urgent cases, treatment may need to start right away. Later, you may still be able to revisit the plan.
Be open and honest about your concerns. Know that the process of getting a second opinion may take time and multiple conversations.
Finding reliable information
If you are searching for clinical trials, the best resource is clinicaltrials.gov. But you do not have to find the information all by yourself. Ask members of your care team (such as social workers, nurses, or case managers) to help guide you. There may be only a few true experts on your child’s condition.
What if opinions differ?
If 2 doctors recommend different treatment plans, talk with your care team, social workers, or palliative care specialists. (Palliative care is not only for end of life. It helps families make the best decisions for the child at the right time.)
Ask questions such as:
- “Is this the only curative option?”
- “What are the short-term and long-term side effects?”
- “How often does my child need to be in the hospital?”
If you cannot decide, talk to your primary care team or ask the care providers to go over your child’s case together.
“It is up to the primary treating physician and family to make the ultimate decision,” Pappo says. “The second doctor can give their opinion, but not dictate treatment. Ultimately, it’s a discussion between the primary oncologist and the family.”
Making treatment decisions
Listen to your care team, but remember: You know your child best.
“The right decision is the one that you make,” Foster says. “That’s what I try to encourage my patients and families to accept.
“If the decision you make with your cancer care team only gets you through the next 2 months and then you have concerns, things aren’t going as expected, or questions arise again, and you need to reevaluate, then you can do that,” she says. “But still, that was the right decision at the right time. You move forward and make a different decision at the next time point.”
Trust yourself in the process. Most doctors want the same thing that you do: the best outcome for your child.
Key takeaways for caregivers
- Second opinions are common and encouraged.
- Be open with your current health care provider—they can help.
- Bring all medical records and test results, including imaging.
- Write down your questions.
- Ask if there is time before delaying urgent treatment.
- Use trusted resources like clinicaltrials.gov.
- Lean on your care team and community for support.
