What to do if pheochromocytoma is diagnosed

This topic is suggested by Dennis.

First of all, making the diagnosis of pheochromocytoma is not a trivial decision. It means more imaging studies and the eventual surgical operation. The patient has to ask two questions: 1) whether the diagnosis is correct, and 2) if the diagnosis is correct, how to proceed with further workups and management.

The experience of the doctor who makes the diagnosis is probably the most critical indicator of whether the diagnosis is correct. The average physicians see few patients with pheochromocytoma in their entire professional life, and they make the diagnosis themselves for even fewer patients. A reasonable question the patient needs to ask the physician is "how many patients with pheochromocytoma have you taken care of?" Most doctors won't be offended by this question. If the doctor has seen fewer than 3 patients, the doctor's experience on pheochromocytoma is too little to make an accurate diagnosis.

The other factor is the doctor's practice environment. Doctors affiliated with an academic center with a large experience on pheochromocytoma have more resources on pheochromocytoma. They know physicians with more experience, they know which radiologists to refer the patients to, and they know which surgeons have the best reputation on pheochromocytoma resecton.

The best doctors on pheochromocytoma are those working in an academic center and doing clinical research on pheochromocytoma. These doctors deal with this disease as part of their career and they have accumulated a large experience on this tumor. They also usually have a program on systemically follow patients after surgical resection.

If the diagnosis is made by an experienced physician, the diagnosis is probably correct. If the diagnosis is made by an inexperienced physician, it may not be necessarily correct, and to have a second opinion from an experienced physician is very prudent. If the patient has the means, it is always a good idea to have a second opinion from another experienced physician even if the diagnosis was already made by an experienced physician, especially when the first physician was not very sure.

To select a surgeon follows the same logic. The best surgeons are those working in an academic center with a large experience on pheochromocytoma and they have operated on more than a few patients with pheochromocytoma. They have seen the tricky perioperative course and work closely with endocrinologists.

As Dennis puts it, a patient should not settle for mere convenience after diagnosed with pheochromocytoma for the first time. Seeking opinions from experienced physicians is very important.