Pathologists are among the most important members of a patient’s cancer care team. They work to diagnose and determine the stage of cancer, setting the course for what comes next in the treatment journey. Years of experience go into preparing and writing a pathology report. A better understanding of that process may offer cancer patients peace of mind and confidence in their care plan.
Dr. Bradford Tan, who chairs the Department of Pathology & Laboratory Medicine at Cancer Treatment Centers of America® (CTCA), likens his role to that of an air traffic controller. Patients may not know he’s there, but he is an integral member of their care team, providing crucial information that helps shape their treatment plan.
“Most people are familiar with taking a flight from point A to point B. Most of the time, they see the pilot and the flight attendants, but what they don’t see are the people in the control tower,” says Dr. Tan. “We guide the care behind the scenes.”
Pathologists analyze tissue under the microscope, looking for signs of cancer. They then consider other factors, such as tumor size and markers that indicate the cancer has spread to the lymph nodes or other parts of the body. Pathologists also help recommend appropriate treatments by studying whether the tumor is likely to be sensitive to certain chemotherapy drugs, hormone treatments or other cancer therapies.
“Cancer is a rapidly changing field, probably with the most new drugs of any disease area,” says Dr. Pamela Crilley, Chair of the Department of Medical Oncology at our Philadelphia hospital. “I think it’s important nowadays for cancer patients to see a specialist, and I would include pathology as well.”
Advances in the science of genomic testing have increased the array of targeted drug options. Last year, the U.S. Food and Drug Administration approved nine new cancer drugs, and expanded approvals to include new uses for six previously approved cancer drugs. The richer breadth of treatment possibilities requires a pathologist’s experience. So now, the pathologist is also called on to assess how sensitive cancer cells appear to the new therapies. That way, the wide range of options is considered, even those still being studied in clinical trials. A marker on the antibody’s other end offers clues as to whether a specific therapy may help fight the cancer. Pathologists may also look to genomic tests to assess whether a targeted therapy, either one that is on the market or one being tested in clinical trials, may offer another option.
When training aspiring pathologists, Dr. Fernando Garcia, Pathologist at our cancer center in Philadelphia, likens their work to the popular children’s game, Where’s Waldo. Pattern recognition is important. “Not everybody can do it,” he says. “If you can find me Waldo in 30 seconds, you’ve got it.”
Learn more about the role pathologists play in cancer diagnosis and treatment.
Find out what the era of genomic medicine has meant to the field of pathology.