A second opinion is a very well regulated medical procedure involving the personal evaluation of the patient and broadening all the studies considered necessary in order to finally issue an opinion in writing.

This is obviously not something that our 'Ask a doctor' department can do because its purpose is only to provide guidance and advice for patients and their families.

Every Autonomous Community must by law, provide a regulated administrative procedure for making an official request for a second opinion. Additionally, some insurance companies provide a second opinion service. 

You can consult some of the different Autonomous Community resources here:

Andalusia, Aragon, Asturias, Balearic Islands, Canary Islands, Cantabria, Castilla-la Mancha, Castilla y León, Catalonia, Community of Madrid, Community of Murcia, Extremadura, Galicia, La Rioja, Navarra and the Basque Country.

The Josep Carreras Foundation can not respond to any individual requests for financial assistance. The best way for the Foundation to help everyone suffering from this disease is to devote all its resources to scientific research and to the search for non-related donors for patients requiring a transplant who do not have a compatible donor in the family.

Neither the Foundation nor the Institute have facilities for medical consultations because they are not health care providers. Our main task is research into blood diseases, finding finding compatible donors for patients requiring a transplant, and providing information and advice to patients and their families.

It is a pleasure for us to clarify any doubts you may have and to offer advice about the process you, or one of your family members, are in. However, it must be remembered that our responses can never be an alternative to the information given directly to patients by their doctors because they will never be as complete and accurate as theirs. Therefore, if we see that a certain patient or family member is systematically questioning every step in the process, we must reluctantly cease providing consultation and advise then to consult their doctor.

Should it be necessary to resort to a clinical trial to treat a blood disease that can not be controlled with the usual treatments, what would normally happen is for your doctors themselves to mention the clinical trials that might be useful, and where they are being held.

Bear in mind:

1) In the event of a clinical trial existing that is appropriate in your case, you must provide complete clinical documentation and also complete various administrative procedures in order to change centre, something that is especially important if the trial is taking place in another Autonomous Community. The centre that is treating you must also be involved in this process.

2) There is little point in undertaking the usual 'pilgrimages' in search of an appropriate clinical trial because such searches often end in foreign centres that accept all kinds of patients (regardless of the possibilities for success) as long as they can pay the astronomical sums of money they ask for.

3) If there is a drug undergoing clinical trials that has proved minimally effective, there will be a centre somewhere in the country that is using it. The website of the  Agencia Española del Medicamento (Spanish Drug Agency) lists all the trials underway.

There is nothing more complex than recommending the diet to follow for a patient receiving chemotherapy or who has received a hematopoietic transplant because it will vary from patient to patient depending on their tolerance for food, the treatment already received and the treatment being received, and finally, the degree to which the body's defences have recovered.

It is, therefore, only the doctor who is treating the patient who can give an accurate recommendation about the diet to follow.

On our web and blog you will find some general recommendations, but remember, you must always ask your doctor if they apply to you or not. On this page you will also find links to websites in Spanish by other international organisations. 

In Spain access to the drugs depend on the kind of drug in question:

1) Drugs dispensed at the hospital: These can only be obtained at the hospital itself by patients being treated there.

2) Drugs dispensed at pharmacies with a prescription (a large majority) They can be obtained at a pharmacy if they have been prescribed by a doctor.

3) Drugs available over the counter at the pharmacy.

Therefore, when we are asked to supply a drug due to lack of supply from the patient's country of residence, that drug will normally be one in the first two groups. Our Foundation is not a health centre and we can not attend to patients, and neither do we have access to pharmaceutical products.

The Spanish Health Service has tertiary referral hospitals distributed throughout the country. All of them have a Hematology Service equipped and ready to treat any kind of blood disease.

Some of them focus their attention on specific illnesses or procedures, and others have great experience due to the large number of patients they treat, and all of them are capable of treating and managing patients with the most usual illnesses. We therefore always recommend patients to consult the nearest University Hospital or tertiary referral hospital to their place of residence about this question.

Chemotherapy consists in the administration of drugs that destroy leukaemia cells.

The answer to this question is so extensive that it is not possible to provide an answer to it by email. We have therefore included a section on our website with some basic information on this subject that all patients and their families can consult.

There are also links to other quality websites in Spanish by international organisations. Additionally, on our BLOG 'Unstoppable against leukaemia' you can find articles about other subjects of interest, such as carers, diet, catheters, etc.

A transplant hematopoietic progenitors is another option for treatment that may be considered for certain patients. The patient's bone marrow that is producing the malignant cells is destroyed through the administration of high doses of drugs and radiotherapy, and then replaced with healthy bone marrow. 

The answer to this question is so extensive that it is not possible to provide an answer to it by email. We have therefore included a section on our website called “Bone marrow transplant guide” that all patients and their families can consult.

It provides information about all aspects of this procedure, as well as its advantages and its drawbacks. 

Our organisation works with Spanish hospitals authorised by the Spanish Health Service to perform bone marrow transplants and with registries abroad to offer voluntary donors for patients who require a transplant.

Our Foundation administers the Spanish Bone Marrow Donor Registry (REDMO), created to attend to the needs of patients being treated in the hospitals of the Spanish National Health Service who need to find a voluntary donor because they do not have a compatible donor amongst the members of their own family.

Our registry is linked to all the other countries around the world world that have a similar registry. in this way we can search for bone marrow for Spanish patients, and offer donors for patients abroad in countries that have a registry.

Latin-American countries that DO have accredited bone marrow registries with international access are:

- Mexico

- Argentina

- Brazil

- Uruguay

These registries can initiate an international search for a compatible bone marrow donor and therefore have access to more than 33 million bone marrow donors there are in all the world's registries, as well as more than 700,000 units of umbilical cord blood.

The other Latin-American countries do NOT have an international registry and, in many cases, neither do they have hospitals authorised to perform allogenic (non-related) bone marrow transplants.

The Josep Carreras Foundation's REDMO registry offers the possibility of a search for a donor for those Latin-American countries that do not have a registry. The only conditions required are that the request for a search be initiated by the centre (never family members) that will perform the transplant and that that centre document sufficient experience in this kind of procedure. You can find much more information and many more resources for Latin-American patients here.