The Peculiar Pathology of Cancer

Pathologists meet in a regular conference to discuss cases as they examine tissue samples.

The Peculiar Pathology of Cancer

July 17, 2010  |  Department News

The pathologist is a critical player on any cancer patient’s team

If you were to believe television shows like CSI, you might think pathologists only perform autopsies and solve murder mysteries. But most pathologists work in laboratories, diagnosing diseases such as cancer by examining tissues of patients who are very much alive.

Saul Suster, MD

Saul Suster, MD

The pathologist’s work is often “behind the scenes” from a patient perspective, even though pathologists work directly with the treating physician. Pathologists advise oncologists on the type of cancer they’re dealing with, offer ideas of what to expect regarding the biology of a tumor, and provide tools to help physicians decide on a treatment.

“An incorrect diagnosis of breast cancer, for example, could lead to unnecessary treatment. An incorrect diagnosis of benign breast disease can lead to a patient missing the chance for a cure.”

“I can’t emphasize enough how critical pathology diagnosis is to a patient,” said Saul Suster, MD, Medical College of Wisconsin pathologist and chair of Pathology and Laboratory Medicine. “An incorrect diagnosis of breast cancer, for example, could lead to unnecessary treatment. An incorrect diagnosis of benign breast disease can lead to a patient missing the chance for a cure.”

Even when a tumor is known to be malignant, physicians need more information from the pathologist to determine if and how radiation or chemotherapy should be utilized.

“Until recently, every pathologist was expected to be proficient in every aspect of pathology,” Dr. Suster said. “As a discipline, pathology offered a handful of specialties. However, a recent explosion of advances in techniques and new information — especially a better understanding of disease at genetic and molecular levels — has made further specialization necessary.

“The advantage of a large, academic medical center is that we have experts who specialize in single organ systems,” Dr. Suster said. “Pathologists obtain more depth and experience in an accelerated fashion under a specialty system. The academic medical center setting also allows the clinician to have more direct communication with the pathologist.”

The Department of Pathology’s resident and fellowship programs also offer specialty training.

Froedtert & MCW Clinical Cancer Center Edge 2010

This story originally appeared in the Frodtert & The Medical College of Wisconsin 2010 Edition of the Edge.
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As the field progresses, pathologists facilitate research that can rapidly be put into practice to help patients. At Froedtert & The Medical College, pathologists are creating an advanced laboratory that will amplify their ability to make accurate diagnoses, understand biological implications of tissues they examine and help predict the path a tumor will take.

Research may also help uncover the body’s direct receptors, which could aid in developing more drugs that target and turn off specific proteins that cause cancer cells to grow.

Dr. Suster’s best advice: “If you have cancer, get a second opinion — especially if you’re dealing with a rare or unusual tumor, or if anything in the pathology report isn’t 100 percent clear.”