The Department of Laboratory Services at Cancer Treatment Centers of America (CTCA) plays an important role in patient care. Our pathologists analyze laboratory tests for cancer diagnosis, staging and treatment planning and monitoring. These tests include those of blood, urine or other bodily fluids. The goal is to ensure that you receive the appropriate cancer treatment plan designed for your needs.
The team prides itself on accurate, reliable and rapid turnaround times for in-house blood tests. Our goal is to eliminate as much of your wait time as possible, so you can receive targeted treatment with fewer delays or interruptions.
Key divisions of the laboratory include processing of blood, chemistry, transfusion services, hematology and urinalysis.
Chemistry and special chemistry
This group of tests uses chemical processes to measure levels of chemical components in the blood or urine to help us evaluate your general health status. Components of the blood include: blood glucose (sugar), electrolytes, enzymes (e.g., creatinine kinase), lipids (e.g., cholesterol), proteins (e.g., albumin, globulins), hormones (e.g., cortisol) and other metabolic substances (e.g., uric acid, blood urea nitrogen or BUN). Some special chemistry tests deal primarily with tests for thyroid function, vitamin B12 and folate, and tumor markers.
- Tumor marker tests: A tumor marker is a substance that can be found in the blood or other bodily fluids which may be elevated in a person with cancer. Aside from detecting the presence of cancer, tumor markers are used to monitor your response to therapy. Tumor marker testing turnaround time is less than two hours from the time blood is drawn to the time the results are sent to the medical oncologist.
Blood bank/transfusion services
One specialty within the laboratory is transfusion medicine, otherwise known as the blood bank. Medical technologists in the blood bank are responsible for ensuring that blood products given to you are compatible with your blood. Donated blood is screened for infectious diseases and tested for antibodies to ensure the blood is suitable for a transfusion. We use the highest level of checks and balances in this department to ensure safety.
Hematology is the study of blood cells and blood-related disorders. Tests performed by this team include complete blood counts (CBC), differentials, body fluid analysis and bone marrow procedures. The results are used to monitor your general health.
- Complete blood count (CBC): CBCs are performed on an analyzer using laser technology, which measures the reflection of the laser light from each individual cell, and in turn, provides cell identification. CBCs are used to gage your ability to receive additional therapy. The analyses may also help diagnose anemia, blood cancers and problems in the bone marrow. A CBC can include white blood cell count (WBC), red blood cell count (RBC), platelet count, hematocrit red blood cell volume (HCT) and hemoglobin concentration (HB) and a differential blood count, identifying the blood cells.
- Coagulation tests: These tests are used to measure platelet function, coagulability and clotting ability to help diagnose and/or monitor bleeding and clotting disorders, as well as anti-coagulation (anti-clotting) therapies (e.g., heparin therapy). Bleeding and clotting disorders can result from cancers such as liver disease, or as a side effect of certain medications.
- Urinalysis (UA) test: This test determines the content of urine to help diagnose infections (e.g., of the kidney, bladder) and disease. It includes examination of color, pH level, red and white blood cells, bacteria and chemical analysis of blood, proteins, glucose and other substances.
Microbiology is the study of disease-causing microorganisms that are too small to be seen with the naked eye. Microorganisms can include bacteria, fungi, parasites, and viruses. Microbiology tests help to isolate and identify infectious agents in the blood, stool, urine, sputum (mucous from the lungs), cerebrospinal fluid, and other body fluids. The Laboratory typically sends microbiology tests to a reference lab, where the infectious agents are tested and the results are sent back via an automated computer system.
The laboratory team at Eastern
The laboratory team at CTCA at Eastern Regional Medical Center (Eastern) consists of medical technologists and phlebotomists, as well as laboratory assistants, analysts, supervisors, and an information systems coordinator.
Pathologist Dr. Fernando Garcia oversees the clinical divisions of the Laboratory, while Ellen Kellom, a medical technologist, is responsible for the department’s day-to-day administration and operation.
The Laboratory staff is extensively trained. According to Kellom, in addition to a bachelor’s degree, most of the medical technologists have also completed six-month to year-long clinical rotations, similar to nurses.
“Everyone on my staff has six years of experience or more,” says Kellom. Also, when they get to CTCA, medical technologists have required training. “Our training can last anywhere from six weeks to 12 weeks in addition to everything else,” she says.
When you first arrive at the hospital and throughout your care, you will receive various laboratory tests. When your physician places an order for a test, it goes into an automated computer system to notify the Laboratory.
To receive your laboratory tests, you will visit the Outpatient Clinic on the first floor of the hospital. In the clinic, a phlebotomist will draw a sample of blood. If you have a central line, or port, a nurse will draw the blood. The phlebotomist station has regular hours from 7:30 a.m. to 4:00 p.m. Monday through Friday, and is available during off hours when needed. Phlebotomists also visit inpatients for early morning rounds and for periodic rounds throughout the day.
Once you have received your laboratory tests, the results will go back into the automated system for your physician to review. This process helps determine your personalized treatment plan.
Eastern’s Laboratory performs an average of 1000 CBCs and Chemistry panels per month. Since the Laboratory is open 24 hours a day, seven days a week, the turnaround time is extremely efficient, even for the tests that are sent out. For instance, the turnaround time for complete blood counts is less than 30 minutes, and it is about 45 minutes for Chem panels (Chem14).
“I’ve worked in other hospitals that have emergency rooms with a standard turnaround of an hour. It means a lot to our patients that we can turn those tests around in less than an hour,” says Kellom.
For tumor marker tests, the turnaround time is about 75 minutes. According to Kellom, the turnaround at other facilities can be anywhere from a day to a week or two weeks. “The fact that we can turnaround these tests in less than 100 minutes is really a benefit to our patients and it is something we are very proud of,” says Kellom.
For microbiology tests, which are sent to a reference lab, a courier comes to pick up the tests four times a day. Depending on the specific test, the Laboratory usually gets the results in 48 hours. According to Kellom, this is very fast turnaround for microbiology tests, considering the time it takes to grow the organisms.
“Even though we don’t do microbiology on site, we do our best to provide as superior a service as we can,” says Kellom. And, since the reference lab directly interfaces with the Department of Laboratory Services via an automated computer system, the process is even more streamlined.
Quality of results
The Laboratory understands that turnaround time is meaningless without attention to quality. After all, your treatment plan is guided by laboratory results. The department makes the quality of results its primary focus.
“Our medical technologists are not only extensively trained, but they are also empowered, to make decisions about the quality of the results. If there is a question in any way about the accuracy or integrity of the specimen or the results, they will question it. They will not put that result out until they feel completely comfortable that it is accurate and right for the patient,” says Kellom.
Putting patients first
The Laboratory puts you and your needs first. According to Kellom, most cancer hospitals batch laboratory tests. This means they do certain tests on certain days of the week. At Eastern, when the Laboratory gets an order, they promptly do the test. “Here, we work for the convenience of the patient,” says Kellom.
The Laboratory is open 24/7, every day of the year.