Confirming your cancer diagnosis

As oncologists, we rely on making cancer diagnosis based on your tissue (usually obtained by biopsy or surgery).   For most cases, our pathologists are very reliable in making this cancer diagnosis.   However, there are some cases that your cancer may not be as common and the cancer diagnosis may not be as certain.

We published a paper a while ago that illustrated this situation.   We did 2nd review of the pathology report of 720 patients and found15 diagnosis were different than the original diagnosis (2% discrepancy rate).  After reviewing 15 major discrepancies, six surgeries were cancelled, two surgeries were modified, one adjuvant radiation treatment was added, one chemotherapy treatment was modified, and five adjuvant chemotherapy treatments were cancelled.

Doctors (pathologists included) are human and medicine is not an exact science.  Differing opinion occurs and may impact the patient's care.  Thus, if your oncologist seem a bit uncertain or if you have a rare cancer, you may request a second pathology review.   Most oncologists that I know will automatically do so without even letting you know.  But it does not hurt to ask.

Reference
Santoso JT, Coleman R, Voet R, Bernstein S, Lifshitz S.   Pathology slide review in gynecology oncology.   Obstetrics and Gynecology.  91 (5): 730-734, 1998