For most people, their pathologist is one physician they’ll never meet.
While pathologists have a big role in defining and labeling the cause of your disease — such as the type of cancer cells or infection — most of us never meet one. Instead, our physician, surgeon or other specialist conveys the information from the pathologist to us. We just pay the bill.
But a pathologist doesn’t have to be like the Wizard of Oz, working unseen behind the curtain. Increasingly, people are realizing the benefit of having a consultation with the specialist who has personally eyeballed their disease, on a slide under a microscope or with another technological tool.
For those who are faced with a choice — such as mastectomy versus lumpectomy, or watchful waiting versus prostate surgery, for example — talking directly with the pathologist can be helpful in many ways.
It may be valuable to actually see the slides that led to your diagnosis and be able to ask questions. Getting the perspective of a physician who has devoted his or her life to identifying disease may be helpful as you weigh different options.
You can talk with the pathologist about how you would go about sending the slides for a second or third opinion, perhaps to a university medical center or specialty hospital. You can explore with the pathologist whether your slides are typical, or unusual, and what that may mean to you as you choose a course of action.
The conversation you have with your pathologist will help you ask better questions of your physician and surgeon as you weigh your options. You will learn things that help you understand the disease better and its likely course without treatment. Just seeing the slides for yourself will give you a realistic mental picture of what you are dealing with.
I have a good friend who had an unusual form of uterine cancer. When she took her pathology slides to other pathologists at two different medical centers, she ended up with a total of three somewhat different diagnoses and options. She was finally able to get the three physicians to talk with each other, and they ultimately agreed upon a course of action. She has been cancer free now for almost 10 years, far more than she was promised. And she feels great!
How do you get behind the curtain to talk with your pathologist? Ask your physician what pathologist and laboratory he or she uses. Request a meeting to review the slides with the pathologist. Explain to your physician that the best way for you to be an effective advocate for yourself is to learn all you can about your challenge. Add that you think talking with your pathologist would be an important part of the process.