Why the Roswell Park Doctor You Never Meet May Be the Most Important Person on Your Care Team
Patients with stomach cancer interact with many doctors during the course of their treatment, but rarely do they meet the specialist who plays a critical role in the outcome: the pathologist who diagnoses their cancer by analyzing samples of blood, tissue and body fluid. Precise diagnosis is what drives patient decisions and therapy. If the pathology is wrong, everything that follows will likely be incorrect as well.
It takes years of training and a specific skill set to become an expert pathologist. After medical school, doctors complete a minimum of four years in a pathology training program and generally pursue additional training in a subspecialty.
Never before have pathologists been so critically important. Recent scientific developments have led to an explosion of information about markers and genomic analysis that helps to identify specific cancer types and pinpoint which one will be more aggressive or more likely to respond to a particular treatment than another type.
Second Look, World of Difference
Even if all you need is a second opinion from Roswell Park, we’re here for you! A second opinion is the best way to reassure you that your initial diagnosis of stomach cancer is accurate and the recommended treatment strategy is right for you! Over a century, our specialists have successfully worked with community doctors, and are happy to discuss and share information, as needed. If you come to Roswell Park for a second opinion, you are under no obligation to receive care or treatment here.
Second Opinion Game-Changer
Roswell Park pathologists reported that 10 percent of patients received a change in diagnosis after coming to RPCI from another care facility.
When Should You Seek a Second Opinion?
It’s always a good idea, but especially important if:
- Your physician or pathologist has not provided you with a full, clear explanation of your pathology report, in a language you understand.
- Your physician tells you that you don’t need a second opinion. A good doctor will suggest that you get another opinion if there are questions about your treatment or diagnosis. If your physician is offended, find a new doctor.
- Your physician wants you to have surgery tomorrow. Almost nothing in the world of cancer care requires that kind of immediacy, except patients with acute leukemia; cases in which a tumor is compressing a vital structure, such as the heart or large blood vessels; or certain other rare conditions.
If you’re still not sure whether to ask for a second opinion, ask yourself:
- Am I confident in the diagnosis or treatment options I’ve been given?
- Am I comfortable with my treating physician?
- Has my physician clearly explained all treatment options — not just the ones he or she prefers?
- Are there clinical research studies offering new treatments for my cancer?
- Was my cancer diagnosed at an office or community hospital setting or in a comprehensive cancer center?
- Does my insurance plan require a second opinion? If not, what type of coverage does it provide for second opinions?
Your Stomach Cancer Pathology Report
The pathologist will report on what was found in the tissue sample from your biopsy. It will include whether cancer cells were found, and what type. The pathology report will also include the followings:
- Tumor grade: How different the cancer cells appear from normal cells
- Tumor depth: How far the tumor has grown into the colon wall
- Tumor extension: How far the tumor has grown into nearby tissues
- Lymph node evaluation: How many lymph nodes were tested and how many have cancer cells (positive)
- Distant metastases: Have cancer cells been found in distant body areas such as the liver or lungs?
- Margin status: Are the areas surrounding the tumor site free of cancer cells?
- Tumor deposits: Are there cancer cells where the lymph drains from the tumor?
- Lymphovascular invasion: Have cancer cells invaded the lymph or blood vessels?
- Perineural invasion: Have cancer cells invaded the nearby nerves?
- Histologic subtypes: What type of cancer cell is found?
- HER2 Neu Expression: The cancer cells are examined for this specific protein, which amplified or overexpressed, is associated with certain cancers such as stomach, breast, ovarian and uterine. If your cancer overexpresses HER2 Neu, targeted therapy will likely be part of your treatment plan.
Cancer treatments are becoming more and more targeted, so an accurate and comprehensive analysis by a pathologist is critical in determining the best approach. Learn more about how to read your pathology report.