Pathology Diagnosis: Do You Need a Second Opinion?
7/24/2005 Raleigh, NC staff Cancer Wire (July 2005 Edition) John, age eight, was diagnosed with an Anaplastic Astrocytoma (AA) which is an aggressive and often fatal brain tumor. He underwent brain surgery followed by high-dose chemotherapy and radiation therapy (equivalent to about 50,000 dental x-rays). These treatments are highly toxic to the developing brain of a child and, if he were to survive, his IQ and cognitive abilities would be seriously compromised. The family moved to a different state and took John to the local children’s hospital for follow-up care. There, the doctors reviewed John’s pathology slides. They discovered that John’s tumor was not an AA, but was benign. This diagnosis was subsequently confirmed by two other hospitals. John never needed chemotherapy or radiation therapy. Today, John’s IQ decreases at a rate of about 6 points a year as he suffers from the side-effects of a treatment he never needed. Pathology is the medical specialty that deals with the examination of tissues and cells under the microscope in order to arrive at a diagnosis. When it comes to cancer, a pathological diagnosis is the gold standard that indicates the presence or absence of cancer, the type of cancer, and its classification. Because therapeutic decisions are based on the presumed reliability of the pathology diagnosis, a misdiagnosis can result in unnecessary, harmful and aggressive therapy (like John’s story) or inadequate treatment. Unfortunately, medical studies over the last two decades have demonstrated that this gold standard is not consistently reliable. In fact, [...]