10 Questions to Ask Your Doctor (oncologist) 


Asking the right questions can help you understand important information about your cancer diagnosis. Here are 10 questions to ask your oncologist:

1. What types of diagnostic testing do you perform? An accurate diagnosis is critical because it is the basis upon which your treatment plan will be determined. For example, PET/CT scans help determine the precise location of cancer in the body to accurately plan treatment. Tumor molecular profiling identifies a tumor’s unique blueprint to choose targeted chemotherapy drugs. It’s important to have access to advanced diagnostic tests, as well as physicians who are experienced in performing them.

2. What does my diagnostic testing tell me?

The information you should receive from diagnostic tests includes: where the cancer originated, the size of the tumor, the stage of cancer and whether or not it has spread to the lymph nodes or other parts of the body.

3. What treatment options are available? What do you recommend and why? Many types of cancer have a variety of treatment options available. Your doctor should be able to explain the potential benefits of each to help you understand your options, even if he or she doesn’t perform a specific treatment.

4. What happens if a treatment approach doesn’t work for me? At any point, you should feel comfortable asking your doctor about the status of your treatment. When choosing a care team, you may want to consider doctors willing to try new therapies, depending on your response. Look for professionals who will tailor treatments to your specific diagnosis, and who are willing to pursue other options if your treatment isn’t progressing as expected.

5. What are the side effects of treatment, and how often do your patients experience them?

No two people will have the exact same response to cancer treatment, and side effects may vary depending on what type of treatment you choose. Ask your doctor what side effects you might experience, so that you can plan ahead and choose with all of the information you need.

6. How will you help me manage side effects?

Integrative therapies can help prevent or manage side effects, so you stay strong and avoid treatment interruptions. Some therapies that can support your wellness during cancer treatment include: nutrition therapy, naturopathic medicine, mind-body medicine, acupuncture, oncology rehabilitation, spiritual support and pain management. Ask your doctor if any of these are available at your hospital, and how they can be incorporated into your treatment plan.

7. How many patients have you treated with my type and stage of cancer, and how successful have you been?

Ask how much experience your doctor has treating your type and stage of cancer and whether he/she is a board-certified specialist. You may also want to ask about his/her facility’s treatment results so you can see how successful they have been in treating your cancer type.

8. Who will be involved in my care, how often will they meet and who is my main point of contact?

An integrated care team including a surgical, medical, and/or radiation oncologist; dietitian; naturopathic oncology provider; clinical nurse and medical advocate (often a nurse care manager) can ensure you get support for your entire well-being during treatment. If you don’t already have a team like this in place, talk to your doctor about assembling a multidisciplinary team.

9. Where will all my treatments, appointments, tests, etc., take place?

When looking for a treatment facility, consider the coordination and convenience of your treatment. Having appointments and procedures in one location can make treatment less stressful for you, and it may allow you to start treatment sooner.

10. How will you help me balance my cancer care with the demands of my normal life? Your cancer treatment should adapt to your individual needs, and family and professional obligations. Talk to your doctor about your personal needs, so that all aspects of your life are considered when choosing a treatment plan.

For more information on getting a second opinion on  your treatment contact us on http://www.GrandOpinion.com .


Is Surgery the Only Option?

A lot of doctors now recommend surgery to their patients but is surgery really the only option??

It is indeed overwhelming to see the kind of development India has seen in the field of medicine. From bringing in the latest technology for diagnosis and surgeries to having internationally qualified doctors, India has become a medical hub and people from across the globe come here for treatment. Despite all this development, people are still misguided into unecessary tests and surgeries.


Surgery 1

Image- http://www.timesofindia.com

According to a study done by the Times of India a resident of Kandivili, Gautam Sharma had severe left shoulder pain and was advised cardiac surgery the very next day itself. But he has a feeling it had nothing to do with the heart but to do with the shoulder bone itself. He took a second opinion and sent his ECG to a doctor in the US who in turn connected him to an orthopaedic surgeon there. The orthopaedic surgeon said his bones were not aligned properly and that was causing the pain. He was taught some exercise and today his pain is much better and he is leading a normal life.

According a study done by an organisation specializing in second opinions in Mumbai on 12,500 patients almost 44% of the patients were advised against surgery when they went in for a second opinion. This is the situation in India, but that does not mean that doctors in USA do not recommend surgery. According to a study done by USA Today (www.usatoday.com), Jonathan Stelly a pro baseball player fainted once while playing and was rushed to a cardiologist. The cardiologist said he needed a pacemaker if he wanted to live even till 30. He underwent the surgery and had a pacemaker implanted but months later he heard that the cardiologist had been arrested for unnecessary surgeries. He also learnt that all he needed was blood pressure medication! The doctor had not just put him through an unnecessary surgery but also taken away the love of his life baseball. According to US Today in the US unnecessary surgeries account for 10 t0 20% of the surgeries done every year in some fields including cardiac, knee, spine surgeries and hysterectomies.


Surgery 2


An overdose of surgeries has been commonly seen in the field of orthopaedics especially in terms of knee replacement surgeries. The Indian Society of Hip and Knee Surgeons reports that 66,352 total knee replacements were done  in the country in 2013, compared to merely 9,951 cases reported by it in year 2008. Dr C S Yadav, professor, department of orthopaedics at AIIMS says that nearly 30 to 35% of knee replacement surgeries done in India are unnecessary and so patients at AIIMS are being educated about lifestyle modifications and exercises which can help them avoid surgery.


Surgery 3

Image- http://www.whale.to

Another surgery which has become increasingly common in India is a hysterectomy or surgical removal of the uterus. This is usually recommended in women of menopausal age who have excessive bleeding, fibroids, cysts etc. Many women across the country have undergone unnecessary hysterectomies and later regret it. According to a survey done by Oxfam in a village in Rajasthan, out of 285 women investigated to, 258 had undergone hysterectomies in 6 months and the youngest amongst these was just 18 years old. These surgeries simply exploit the rural women who really don’t need surgeries and are threatened into having these surgeries putting fear of cancer into them.

Surgeries and Cancer

Being diagnosed with cancer itself is a very stressful situation and if you are advised surgery it is going to worry you even more. Please relax and understand why the doctor is advising surgery. According to the Mayo Clinic the doctor advises surgery for cancer to-

  • Firstly diagnose the cancer and see of the tumour if benign
  • Surgery is also preventive if you have developed any tissues or extra growths.
  • To determine the stage in which your cancer is and to decide the line of treatment.
  • As a mode of primary treatment especially if your cancer is in the initial stages
  • Debulking- removing as much of the cancereous tissue as possible so chemotherapy and radiation are effective
  • To relieve stress and pain especially if you have a tumour pressing on a nerve.

Why Unnecessary surgeries?

Surgeries are becoming so common these days that it has become important to understand the reason behind this attitude of doctors and why they are prescribing so many unnecessary surgeries.

  • High levels of medical interventions- including tests which costs a lot and then telling people that surgery is the only option
  • Lavish and unnecessary use of medical technology to do tests and surgeries.
  • Defensive medicine or playing it safe and convincing patients that surgery is the best option
  • Failure to counsel patients on whether the surgery is necessary or not.
  • Aggressive marketing my companies and hospitals regarding surgical procedures.
  • Incentives provided by companies to doctors for performing surgeries.

The patient should decide on whether he or she needs to have a surgery after having-

  • A complete check up by the phyisican or family doctor to decide whether the surgery is required or not.
  • Discussed with the doctor about alternate lines of treatment which can help avoid surgery.
  • Understood the whole procedure of the surgery and why he or she needs to undergo it
  • Understood the benefits of the surgery
  • Taken a second opinion that also indicates the need for a surgery.


Surgery 4

Image- http://www.kingbrand.com

Surgeries are traumatising regardless of what surgery one is undergoing and how good the doctor is. How can one avoid a surgery?

  • Hysterectomy– Menstrual problems like heavy bleeding can we dealt with medicines easily. Simpler procedures like monomyectomy for fibroids, knife free procedures for endometriosis and other lesser invasive procedures are today available for uterine problems and can help avoid surgery.
  • Cardiac procedures– Angioplasties and bypass surgeries have become so common these days. Even for a heart burn doctors tend to misguide the patients that they have a heart problem and first do an angiogram and then say there are blocks and surgery is needed. Instead modifying life style, eating healthy and taking the right medications can help restore cardiac health.
  • Orthopaedic procedures- replacement surgeries are commonly prescribed these days for knee, hip, spine and shoulder problems. Meeting a good physiotherapist and learning the right exercise, losing weight, wearing proper foot wear can all help in avoiding these surgeries.


Surgery 5


 So, your doctor has just broken the news to you that you have a major problem and require surgery and now you are going through that trauma.

Well! Rather than being distressed get up and look around yourself. Second opinion is always there to help you and guide you on your course of treatment.

GrandOpinion (www.grandopinion.com) is a portal which can help you during this time. Just get onto the portal and share your details and reports, let the team of doctors study your case and revert to you. In most cases SecondOpinion has helped to prevent surgeries. A shoulder pain need not be a heart problem, a knee pain does not necessarily call for a replacement and an excessive bleed does not mean hysterectomy. It could just be a red signal for you to stop, slowdown in life and care for yourself. You might just need to modify your life style, diet and exercise or just undergo a minimal non-invasive procedure and you can avoid going under the knife!  GrandOpinion (www.grandopionion.com) can just guide you of a surgery, because surgery is definitely not the only option!




Congenital Abnormalities

Consult for Congenital Abnormalities- End-of-life Care

Consult for Congenital Abnormalities- End-of-life Care

 Regular tests during pregnancy to scan for congenital abnormalities can give a new lease of life to the babies

It is a moment of joy for the couple and the family when the news of a pregnancy is confirmed. And then begins a whole cycle of mixed opinions and advices from friends and relatives that can leave the mother to be rather confused!

It is of prime importance for the pregnant lady to go in for regular check ups and scans to ensure that the baby is not predisposed to any congenital abnormalities. The chances of developing any abnormalities become high if either parent or some family member is suffering from a certain health issue.


According to a success story on prenatal testing shared on www.wired.com , Candice * was happy when she got pregnant but had no clue that her grandmother had a baby with downs syndrome at the age of 42. The baby did not live long. Candice’s first child was born normal but at the time second pregnancy, she managed to conceive only after repeated miscarriages. Her pregnancy was closely monitored by doctors and for a while they thought things were going well. Her doctors made her do a blood test at 10 weeks to check for chromosomal disorders. Right enough the tests revealed the baby had downs syndrome. At 12 and a half weeks she terminated the pregnancy. She has been one of the lucky few moms who did not end up having a baby with downs syndrome and then losing it early. Birth defects are becoming increasingly common but the good news is that tests and scans help to detect these in early pregnancy and help prevent birth of such babies.

A birth defect or congenital abnormality is defined by March of Dimes as, “functional or structural- that presents in infancy or later in life and is caused by events preceding birth, whether inherited or acquired.” In India a large number of birth defects are seen due to various reasons like universality of marriage, consanguineous marriages, many unplanned pregnancies, high fertility and poor antenatal care.

Types of birth defects:

  • Structural defects are physical defects with body parts such as cleft lips, cleft palates, club foot, missing valves or neural tube defects.
  • Function defects include defects in the functioning of the body parts like developmental disabilities, metabolic disorders or degenerative

Reasons for birth defects:

According to John Cunha, birth defects occur either due to genetic factors, environmental factors or problems with chromosomes and are the leading cause of death of infants in the first year.

  • According to the better health channel some of the common causes of birth defects include-
  • Genetic disorders acquired from either parent
  • Maternal illness during pregnancy- example German measles
  • Intake of alcohol or illegal drugs sold over the counter
  • Incompatibility of mother’s blood with baby’s blood
  • Radiation exposure
  • Some birth defects occur due to unknown causes


There are two types of tests used to identify birth defects in pregnancy- screening tests and diagnostic tests. Screening tests help to show the chance of your baby having a birth defect and diagnostic tests help to confirm these birth defects. According to Webmd the list of screening tests are-

screening tests When they are usually done
First-trimester screening (first part of integrated screening) 10 to 13 weeks
Nuchal translucency (usually done as part of the first-trimester screening) 11 to 14 weeks
Cell free fetal DNA (an option for women at higher risk) 10 weeks or later
Triple or quad screening (second part of integrated screening) 15 to 20 weeks
Ultrasound (pictures of baby’s body) 18 to 20 weeks


Diagnostic tests When they are usually done
Chorionic villus sampling (CVS) 10 to 12 weeks
Amniocentesis 15 to 20 weeks

Source: http://www.webmd.com/baby/tc/birth-defects-testing-what-are-the-tests


The different types of birth defects that are commonly seen include-

  • Congenital heart defects which occur in 1 out of every 110 births. The symptoms of these defects include rapid heart beat, breathing difficulties, pale skin, swelling in the limbs and feeding problems. Surgery, mechanical aids like pace makers and drugs help to rectify such birth defects.
  • Club foot affects 1 in 400 babies and if diagnosed in initial stages it is treated by just trying to put the foot in place, but in later stages braces and casts or in some cases surgery is used to treat it.
  • Cleft lips and palates are a very common defect and should be surgically corrected 3 months after the birth of the baby.
  • Congenital scoliosis: The term “congenital scoliosis” refers to a spinal deformity caused by vertebrae that are not properly formed. This occurs very early in development–in the first six weeks of embryonic formation
  • Spina bifida or malformation of a neural tube is another common defect and could be harmless or can cause severe problems like bowel control issues and paralysis. Treatment is according to the severity of the problem.
  • Missing limbs, sickle cell diseases, metabolic disorders like phenylketonuria (PKU), downs syndrome, Fragile X syndrome a chromosomal disorder are the other birth defects which are commonly seen in pregnancies and in babies.


Prevention they say is always better than cure and if taking certain small steps can help you have a smooth pregnancy and give birth to a healthy baby then these little steps are definitely worth taking.

  • Increase intake of folic acid as it helps to reduce the risk of the baby getting neural tube defects.
  • Avoid alcohol, drugs and smoking
  • Plan your pregnancy well
  • Prevent infections and take all required vaccinations as infections from a mother can prove to be fatal for the baby
  • Control chronic conditions like diabetes, epilepsy, high blood pressure etc by consulting your doctor both before planning the pregnancy and during the pregnancy.
  • Eat right and maintain a healthy weight
  • Learn about genetics and ensure there are no genetic issues in either parent.
  • See a doctor regularly

If you still require more help, portals like www.grandopinion.com can be like a guide to you both while you plan your pregnancy and all through your pregnancy to ensure that you give birth to a healthy baby.


Your doctor has just given you the most dismal diagnosis that your baby has a birth defect. You are still in the early stages of your pregnancy and wondering if you should continue with your pregnancy, how will the future of your baby be? You certainly need a Second Opinion and this is the time when GrandOpinion can make a difference to your life. We believe in helping with not just treatment but also with prevention.

GrandOpinion can help with

  • Planning your pregnancy in such a way that you can prevent any birth defects from
  • If a birth defect is seen in early pregnancy, guide you on whether to continue with the pregnancy or not
  • If a baby is born with a birth defect then put you on to the best line of treatment to ensure a normal future for the

A doctor and guide like no other, GrandOpinion can indeed help you at every step of your pregnancy and help bring a healthy baby into this world.

Drug Trials-give a Second Chance to That Critical Disease

Drug trials can be the light at the end of the dark tunnel for many patients dealing with critical diseases

Leading a normal life, being physically active and eating right- everyone tries to follow these to stay healthy! But suddenly when a normal person discovers a lump, a cyst, or has a persistent cough, uncontrolled bleeding or any other major problem and finally comes to know about some critical disease he or she is diagnosed with their life just comes to a standstill!

Of course technology has grown by leaps and bounds and the latest treatments are available in the market for all different types of health problems, but still there are those few people who end up with a bug of a different kind and at times need a new drug to help them! The answer to their problems is clinical trials.

Clinical trial- a test or a solution


Image Courtesy: www.debbiesdream.org

A clinical trial is usually a study involving patients-usually known as the subject- to improve medical knowledge, to prove that certain drugs are successful and can be used to treat humans. Usually there are two types of studies- clinical trials and observational studies. Clinical trials involve the use of drugs or devices to see the safety and efficacy of the product and observational studies assess health outcomes in groups of people.

The two main purposes of a clinical trial are to know

  • Does the new treatment work well on humans?
  • Is the new treatment safe?

These trials go on in many phases and a clinical trial is only one small phase. Each drug goes through at least 6 years of study before it comes into a clinical trial. And on an average it takes about 8 years for a drug to pass a clinical trial and come into the market. During these trials the doctors have to work closely with the patient’s (subjects) to see the effect of the drugs on them. The biggest challenge of these trials is the fact that not many patients are willing to participate in these trials.  According to the American cancer society less than 5% adults agree to take part in clinical trials involving cancer drugs whereas 60% children take part in trials that is why survival rates of childhood cancer have gone up well in the recent past.


 dt2Image courtesy: https://cern-foundation.org/?page_id=292

 Clinical trials are not simple procedures but involve a series of phases before they are considered successful and the product is ready to launch in the market. Drugs are tested for the first time on patients. It helps to decipher the dosage of drugs which the patients can tolerate.

  • This phase includes pilot trials and final trials to evaluate the efficacy of drugs on the patients to see how it helps to treat or prevent the disease.
  • Trials are demonstrated on patients who will eventually use this medicine prior to submission to NDA (National drug authority) and followed by a study post submission to NDA just before the launch in the market.
  • The last phase involves studies on the medicine even after it is in the market to provide additional information on its efficacy and side effects. This is also known as post marketing surveillance.


dt3Image- http://www.givetocure.org

 Clinical trials not just provide new drugs and devices to the medical field but also give a second chance and ray of hope to people suffering from critical health problems. Critical health problems are life threatening and not having a right cure for it can be even more disheartening for the patients. But clinical trials have proven to help such patients as well and have given them a new lease of life.

Mary James an Afro American was diagnosed with breast cancer and she had a complicated form of cancer which needed multiple lines of treatment. She needed a lumpectomy, followed by chemotherapy and radiation. Just as she finished her line of treatment her oncologist suggested her for a clinical trial of accelerated partial breast radiation. This involves comparing the standard breast radiation which takes 6 weeks with accelerated partial breast radiation which confirms the radiation close to tumour cavity and lasts only 5 days. Mary felt that the trial she went through has not only improved her chances of living longer but has also given her an opportunity to do something to make the place a better world.  The outcome of these trials definitely provide a better chance to people suffering from critical diseases towards a new hope of living.

Clinical trials provide solutions for other problems as well like osteoporosis, diabetes, Alzheimer’s to name a few. Osteoporosis is a metabolic bone disorder which involves thinning of the bone. A recent trial done at the Oregon Osteoporosis centre at Portland has shown that a drug called romosozumab, works well on osteoporosis by not just preventing further bone mass loss but also by promoting bone formation.


dt4Image- http://www.genengnews.com/insight-and-intelligence/top-10-clinical-trial-failures-of-2013/77900029/

 A clinical trial is a test of a kind and so not always successful. A drug failing a clinical trial and not coming into the market is better than a drug coming into the market and adversely affecting patients. One such example  is of a clinical trial failure of a breast cancer drug called Cadcyla by Roche as it failed to give results superior to existing drugs. Several anti-inflammatory drugs have been withdrawn from markets following side effects during clinical trials. A failure in a trial is like a red signal to the pharma company to stop it from launching in the market.



A diagnosis of a critical disease, multiple lines of treatment and your doctor requesting you to be part of a clinical trial- leaves you rather confused. If you are wondering who can guide you at this point of time, then the simplest guide and friend you can find is GrandOpinion. If you are dealing with a life and death situation and Inspite of regular medication and treatment, you see no improvement in your disease, and your doctor sees no ray of hope for your living, you can consult GrandOpinion for that second trail to life i.e. for clinical trials.

  • Has your doctor told you about clinical trials? If not our doctors on GrandOpinion will guide you and tell you more about clinical trials and how they can help you find a line of treatment for the critical disease you are suffering from.
  • Has your doctor been asking you to through clinical trials? In this case, GrandOpinion will help let you know if there is any other line of treatment available or clinical trial is the last option.

Apart from these, the effects and side effects will also be clearly mentioned by our doctors.

A clinical trial is a good option for many as it not just helps your problems and increases your chances of living but having been part of a trial you provide a great path for the future generations to come.



Second opinion – A new beacon of light

Second medical Opinion is quite important for critical illness and diseases. With the rise of medical experiments, new treatment procedures, medical negligence and inaccurate diagnosis, this importance has elevated to another level. Getting a second opinion on illness, patients not only get an access to accurate diagnosis and newer treatment paths but also a different perspective on the illness.

The success and innovations in the medical industry across the world are beyond any shadow of doubts. The infrastructure, quality health services, medical devices, constant research and development in pharmaceuticals etc all lead to the growth of the industry. Constant medical technology innovations head to better clinical outcomes and shorter recovery time. So the question arises- why do patients still seek second medical opinion? Is it lack of trust on the doctor’s diagnosis or is it the lack of relevant information to assimilate or you want to know best options available to tackle with the disease.

Healthcare is the most sought after industry in the world. But with the boom of the healthcare industry, an equal percentage of cases pertaining to medical negligence and wrong diagnosis are coming into the picture. Also we can’t neglect the fact, that corporates run hospitals and issue revenue targets to the doctors. Doctors in turn search for potential candidates (a.k.a patients) to perform unnecessary surgical procedures which ultimately add to the overall revenue of the hospital. There have been numerous instances of doctors mis-diagnosing patients or insisting on unnecessary surgical procedures.

WHO lists Medical misdiagnosis among the top 10 killers in the world. As per British National Health System survey conducted in 2009, 15% of its patients were misdiagnosed. Another report by The Pennsylvania Patient Safety Authority, Diagnostic errors are present across every specialty. For perceptual specialties (like radiology, dermatology) the percentage of error is less than 5% but for other clinical critical specialties the error percent ranges from 10% to 15% in US.

Ashish Dhar and Sachin Shah formed GrandOpinion, a place where anyone can get a second opinion on their medical illness from the industry experts. When one of the founders underwent a similar situation of misdiagnosis in his family, the duo realized the need of any such organizations and thus they wanted to bring about radical change in the way patients interact with their doctors. GrandOpinion use a simple flow “right diagnosis to be made at the right time”.

In India there is a wide spread of ‘white coat syndrome’ i.e.  the doctors are kept on a pedestal by the patients and their families. Most of them blindly follow the instructions without questioning or understanding them. Though this is changing slowly with the advent of internet. But many a time self – medication or self – diagnosis can be dangerous as internet mostly provides us with unnecessary and unauthorized information which may confuse the patient and they may land up to a riskier position.

In the urge of eliminating this risk and providing patients with accurate diagnosis, GrandOpinion got its identity. The company launched its branches in USA, Delhi and in China. Ashish Dhar, Co-founder, GrandOpinion shares “We have created a simple no fuss model which is easy to use for patients and their families. With the help of technology, it is easier to seek opinions for top medical professionals at click of a button without having to travel or spend a lot of money”.

GrandOpinion is for patients who are battling with serious health conditions and in need of immediate second medical diagnosis.  GrandOpinion provide patients a different perspective on their disease, with positivity and a better path towards recovery. Apart from individuals, corporate houses and organizations can invest in this service of Second Opinion as it helps employees get accurate diagnosis from the beginning. GrandOpinion has a virtual clinic which matches patient to doctor who are specialized for a  particular medical condition or disease . This is done to ensure that both patient and doctor are connected on the same level and immediate diagnosis can be given without having to resort to unnecessary repeat tests. Opinions are given on basis of existing test reports and a case coordinator is assigned to keep track of the case. Since all the records and conversations are digitally recorded, it can be accessed anytime from anywhere. All consulting doctors in GrandOpinion are recruited only on basis of recommendation and their research in a particular specialty.

Medical diagnosis varies from one physician to another. By taking a second opinion, one can choose between new options for treatment and can cross verify the original diagnosis and treatment plan. GrandOpinion helps patients and their families to make informed treatment choice and choose a better treatment plan.

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