GIST Specialist for Rolling Hills Estates, CA
Most people who want a second opinion on a cancer diagnosis never ask for one, usually because they do not want to seem ungrateful. This page is about how to get one without that friction, and when it is genuinely worth the trouble.
- Second opinions given without pressure to transfer care
- Clinical Professor of Surgery, Cedars-Sinai Medical Center
- Records requested directly from your existing physician
- Remote review before you drive the peninsula
The Obstacle Is Usually Awkwardness
Patients rarely avoid second opinions because they think the first was sound. They avoid them because asking feels like an accusation, because they like their doctor, because the appointment took three weeks to get and they do not want to appear difficult. Those are entirely human reasons and they lead to significant operations being accepted without examination.
Worth knowing: within oncology, second opinions are unremarkable. Many physicians suggest one before major surgery without being asked, and specialist centres are structured around receiving them. Nobody at the receiving end regards it as unusual, and a doctor who reacts badly to the request has told you something useful about how they handle disagreement generally.
The framing that works best is about the decision rather than the doctor. This is a big operation and I would like a second view before committing, could you help me get the records together. That is a request for assistance, and most physicians respond to it as one, often expediting the records because they would rather it be done properly.
For gastrointestinal stromal tumors specifically the calculation is favourable. These are almost never urgent, so a week or two costs nothing clinically. And because the tumor is rare, the questions where opinions genuinely differ are specific and answerable: whether surveillance is safe, whether the pancreas or the sphincter can be spared, whether medication should precede surgery. Those are the sorts of disagreement worth surfacing before an operation rather than after.
Concrete Reasons to Seek Another View
General anxiety is a poor reason and it rarely produces a useful consultation. These are specific grounds, and each one names something answerable.
| Situation | Why it matters | What a second opinion may change |
|---|---|---|
| A Whipple procedure has been proposed for a duodenal tumor | One of the largest operations in surgery, often more than a GIST requires | Many duodenal GIST can be removed with the pancreas preserved |
| A permanent stoma has been proposed for a rectal tumor | Irreversible once performed | Medication first can shrink the tumor away from the sphincter, allowing preservation |
| Most or all of the stomach is to be removed | Permanent change to how you eat | A wedge resection is sufficient for most gastric GIST, since lymph nodes are rarely involved |
| You have been told the tumor is inoperable | Unresectable and not yet resectable are different conclusions | A course of targeted therapy frequently converts one into the other |
| Nobody has told you your mitotic index or risk category | The plan is being made without its main input | A calculated risk category may indicate no medication is needed, or that three years is |
| No mutation testing has been done | Determines which drug works and at what dose | Some subtypes derive no benefit from standard imatinib at all |
| You were told to watch it, with no reasoning given | Surveillance is often correct, but should be justified | Either confirmation with a written schedule, or a change of plan |
If none of these apply and your plan has been explained with the numbers behind it, you may not need a second opinion. Being told that is also a legitimate result.
How It Actually Works
You need three things: the imaging in its original format rather than the report, the full pathology report including the mitotic index and any mutation testing, and the operative report if you have already had surgery. Your existing physician office can send these directly, which is usually faster than requesting them yourself.
From there the review can happen before any in person visit. That matters from the peninsula, where the drive is forty to fifty minutes each way. Send the material, get a specific opinion on whether the proposed plan is sound, and travel only if there is something to discuss that warrants it.
If the opinion agrees with the first, you proceed where you started with more confidence than before. If it differs, ask both parties to explain the reasoning rather than deciding on manner or seniority. And if you would prefer to have the surgery at your original institution regardless, that is perfectly reasonable and you will not be pushed otherwise.
Something You Can Assess Yourself
Recordings of real GIST resections narrated by the surgeon who performed them. Very few surgeons publish their own work, which makes it unusually assessable evidence when you are weighing opinions.
Laparoscopic Resection of a Gastric GIST
A gastric GIST removed through small incisions with the capsule kept intact.
Gastric GIST Resection: A Simplified Approach
A refined approach that shortens operating time and recovery.
Robotic Resection of a Duodenal GIST
Duodenal GIST removed robotically with the pancreas and bile duct preserved, the operation most often replaced by a larger one.
Start With the Records
A remote review of material you already have costs an appointment and no travel. If your existing plan is sound you will be told so, which is worth knowing before an operation rather than after.
Certifications and Appointments
Two American Board of Surgery certifications, a Cedars-Sinai teaching appointment, and membership of the societies that set the standards for this disease.
- American Board of Surgery, certified in General Surgery
- American Board of Surgery, certified in Colorectal Surgery
- California State Medical License
- Florida State Medical License
Joshua Ellenhorn, MD, FACS
Dr. Ellenhorn is a surgical oncologist and Clinical Professor of Surgery at Cedars-Sinai Medical Center, and a collaborative member of the Samuel Oschin Comprehensive Cancer Institute.
A meaningful proportion of these consultations end with the patient going back to the doctor they came from. That is the correct outcome when the original plan was sound, and treating a second opinion as a recruitment exercise would make the whole thing worthless. What the appointment is for is examining a specific decision, and sometimes the honest answer is that it has already been made well.
He is certified by the American Board of Surgery in General Surgery and in Colorectal Surgery, a Fellow of the American College of Surgeons, and a member of the Society of Surgical Oncology and the American Society of Clinical Oncology. He practises with the Surgery Group of Los Angeles.
What Patients Say
Reviews left by patients treated by Dr. Ellenhorn at the Surgery Group of Los Angeles.
★★★★★I was very pleased with the office staff, they were always very pleasant and helpful. I was very impressed with Dr. Ellenhorn as well. He was very friendly and addressed all my concerns regarding my surgery and aftercare and follow up.
Terry Jackson
★★★★★The staff at the Surgery Group of Los Angeles are wonderful. They are kind, very attentive, the office is clean and I did not have to wait long at all. I cannot say enough great things about Dr. Ellenhorn. He is an excellent surgeon who is highly skilled and very knowledgeable. I cannot thank him enough for all he has done for my family and I.
Erika Frank
From the Peninsula
Hawthorne or Crenshaw north off the hill to the 405, then the 10 east and north on La Cienega to 3rd Street. Forty to fifty minutes depending on the hour, and longer if the 405 is behaving as it usually does.
Given that, remote review is generally the sensible first step from Rolling Hills Estates. Most of what a second opinion rests on is documents and imaging, both of which travel electronically. An in person visit makes sense once there is something specific to discuss.
When you do come in, the office is in the medical plaza attached to Cedars-Sinai Medical Center, so consultation, imaging review, pathology and any procedure happen in one building rather than across several trips up the coast.
8635 W 3rd St, Suite 880W
Los Angeles, CA 90048
Monday to Saturday, 11:00am to 8:00pm
Closed Sunday
Frequently Asked Questions
Will my doctor be offended if I ask for a second opinion?
Do I need my doctor permission?
How do I raise it without it sounding like distrust?
Will seeking a second opinion delay my treatment?
What if the second opinion agrees with the first?
What if they disagree?
Do I have to change doctors if I get a second opinion here?
How far is your office from Rolling Hills Estates?
Ask for the Records, Not Permission.
A second opinion before major abdominal surgery is routine, and your doctor almost certainly expects it. The material you need is yours already.
