Second opinion in het buitenland

Objective

To explore motives and experiences of patients with incurable cancer who are looking across the border for second opinions or treatments or are considering to do so.

Design

Qualitative, semi-structured interview study.

Method

A total of 24 patients with incurable cancer from two Dutch hospitals were interviewed by phone. All interviews were coded independently by two researchers and then analysed inductively, without any pre-specified theoretical framework.

Results

Patients were looking for second opinions or treatments because they found it very difficult to accept a sudden diagnosis of incurable disease. They experienced little guidance during this transition. Patients felt they were not offered any treatment options because of imperative protocols. Many patients were in great need of some form of hope. There were often high expectations – unrealistic or not – of the possibilities abroad. Oncologists’ reactions to patients’ choices were very diverse. While disapproving reactions were unable to influence patients’ choices, well-substantiated arguments were sometimes successful in influencing patients’ choices.

Conclusion

More guidance seems advisable for some patients to help them deal with a diagnosis of incurable disease. Dutch oncologists might be able to offer alternative forms of hope to these patients, who have a great need for this. If physicians speak with patients about what a treatment abroad may or may not be able to provide, this might benefit patients.

Conflict of interest and financial support: potential conflicts of interest have been reported for this article. ICMJE forms provided by the authors are available online along with the full text of this article.