All treatment decisions rest on the presumed steadfastness of a pathological diagnosis. Proper pathological diagnosis is important for adequate treatment, and for avoiding overly aggressive and harmful therapy.
It is a pathologist who plays an important role in providing the doctor with the information needed for a proper diagnosis and patient care.
Significance Of Pathology In Diagnosing Cancer:
Pathology is a matter of examining cells, body fluids and tissues, often using a microscope, to determine the proper diagnosis of an illness.
When a patient is thought to be suffering from cancer, the Gold Standard for determining if cancer is present or not, the cancer type, and the way to classify it, is a pathological diagnosis.
Pathologist And His Responsibilities:
A physician who studies tissues and body fluids (blood, urine, etc.) under a microscope is called a pathologist. His results help a primary care doctor to diagnose the exact health problem that a person suffers. The laboratory tests allow the doctor to find causes of the chronic illness.
A pathologist performs the following functions too, other than studying the tissues and body fluids:
- A pathologist also examines the tissue biopsy to determine if it is benign, or you have cancer. Then he transfers this information to the primary care doctor. Some of the pathologists specialize in the genetic testing that helps in determining the appropriate treatment for certain types of cancers.
- A pathologist may also recommend steps to maintain a good health and prevent illness. For example, in your annual physical examination, when your blood is drawn, it is a pathologist who performs tests to evaluate your health condition.
- A pathologist also performs autopsies to determine the causes of death or discover information about the genetic progression of the disease. This information not only help the family members for taking preventive measures for their health but also help the researchers in the development of future treatments.
Cancer Pathology Report:
A document containing the results of laboratory examination of cells and tissue under a microscope, and the resulting diagnosis, comprises a pathology report. The report can contain information on the appearance, size, and shape of the specimen as observed with the naked eye. Such information is referred to as a “gross description.”
A doctor who makes such a report after an examination is called a pathologist. A pathology report is very important in the diagnosis of cancer and in determining if cancer has spread to other body parts. It assists doctors in deciding on the best mode of treatment. The pathology report contains highly scientific, medical terms which is a communication between two doctors i.e. an oncologist and a pathologist. Although you have all the right to have a copy of your pathological report so that you may share it with your healthcare practitioner.
How is the tissue obtained for pathological examination?
Usually, a biopsy is the procedure used to remove cells or tissue. Also, cells can be taken from a surgically removed area for pathological diagnosis. These cells are then studied under a microscope.
A biopsy can be performed in the following ways:
- Fluid or tissue is withdrawn using a needle
- Tissues and cells of the body areas are obtained after being observed using a thin, lighted tube (an endoscope)
- The entire tumor, or part of it, can be removed by surgery. Normal tissue surrounding the tumor will also be removed while surgically removing the whole tumor, to check the extent of cancer spread.
The biopsy tissue removed is taken to a pathology laboratory, and is then viewed under a microscope, after being sliced into thin sections. This procedure is referred to as a “histology” or “tissue examination.”
The pathologist may also examine the cell material (cytology). Cytological material is obtained from the following:
- Peritoneal (abdominal cavity) fluid
- Sputum (mucus from the lungs)
- Cerebrospinal fluid (the fluid in spinal cord and around the brain)
- Pleural (chest cavity) fluid
- Vaginal/cervical smears.
- Fluid may also be obtained from biopsies.
Time that is taken to obtain a pathology report:
It normally takes up to ten days for the pathologist to prepare the pathology report after the biopsy, which he/she then sends to the physician. The language used in the report is technical medical terminology. Patients may obtain a copy of the pathology report if they so desire, and can receive explanations of the technical medical words from their doctor. It is a good idea for patients to have a copy of the report in their medical records.
Information contained in a pathology report:
The pathology report will contain the following information:
- Information about the patient: Patient’s name, date of birth, the date on which biopsy was performed.
- Obvious Description: Size, color and weight of tissue when observed with the naked eye.
- The description under microscope: Comparison of the cells under examination with normal cells using the microscope.
- Diagnosis: Type of cancer/tumor and grade (how unusual the cells are when observed under the microscope, and how fast the tumor is likely to spread and grow).
- The size of tumor: Measurement of the biopsy taken in centimeters.
- Margins of tumor: When the sample biopsy is of the whole tumor, three possible results can be observed:
– Positive margins indicate the presence of cancer-causing cells at the edge of the biopsy material under examination
– Negative margins, not obvious, apparent, or free margins indicate absence of cancer cells on the outer edge
– Close margins are neither positive nor negative.
- Other information: can be some other opinion or information about previous samples.
- Signature of the pathologist doing the examination, and the laboratory’s name and address
After determining that the tissue sample is cancerous, the specialist can perform other tests to check for abnormal growth, or for tumors that are not easily displayed by normal stains using the microscope. The results of such tests are also recorded in the pathology report.
The pathological reports affect a doctor’s decision in many ways and helps him/her understand the exact illness and the stage of cancer. It also helps the doctor in making a good treatment plan. Pathological results prevent the doctors from giving any harmful drug treatment.