 December 11, 2001 |
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Brain Tumor Survival Guide4. Be sure that the neuropathology is correct.What kind of tumor do you have?After the surgery, your tumor will be examined by a pathologist for what we call a "tissue diagnosis". All of your subsequent treatment - chemotherapy, radiation therapy or no treatment - will be determined by the tissue diagnosis. Your future will depend on what that pathologist says. How do you know that he or she is correct? Many people believe that neuropathology, like general pathology, is a simple black and white field: cancer or not cancer. Objective. Cut and dried. But, in fact, neither general pathology nor neuropathology is so simple. It is highly subjective. One would think that the same tumor would get called the same thing by different pathologists. Wrong! The rate of agreement between pathologists looking at the identical specimens of glial (brain) tumors is as low as 40%! Sometimes a neuropathologist may not even agree with him or herself! Studies have shown that same pathologist looking at the same specimen weeks later will come up with the same diagnosis less than 60% of the time! And we're talking academic level neuropathologists here - not general pathologists at local community hospitals. So what do you do? You need to have your pathology slides looked at by other neuropathologists. If two don't agree, get third, fourth or fifth opinions. Then a good neuro-oncologist can determine which is most likely correct based on your history and the appearance of the tumor on imaging studies (CT and MRI). The fact is that there are only a few competent, experienced and practical brain tumor neuropathologists in the world. We're talking about neuropathologists whose priority is patient care and not trying to set the scientific world on its ear. We know who they are. The Brain Tumor Foundation can make recommendations of these neuropathologists who can review your specimens for you. This may cost you a little money - about $300 to the pathologist per opinion. But it's worth it; your life may depend on having the correct diagnosis made. |
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