Pathology Consultation Clinic for Patients With Cancer: Meeting the Clinician Behind the Microscope.

PURPOSE

Traditionally, pathologists have been branded the doctor's doctor, with a position behind the microscope and limited interaction among patients, despite their rich understanding of disease development and ability to navigate personalized medicine in an era of dynamic molecular testing.

METHODS

We piloted a unique patient-pathology consultation service, whereby pathologists review tissue specimens with oncology patients, facilitating a platform for heightening patient understanding of their disease and guiding additional genetic and molecular evaluation. We conducted a retrospective survey assessing patient experience.

RESULTS

Fifty-nine patients participated in the patient-pathology clinic consultation, with a median age of 64 years and a female predominance (33, 55.9%). The majority of patients were treated for sarcomas (11, 18.6%), breast cancer (10, 17%), and GI tumors (10, 17%). Half of the participants consulted regarding a metastatic disease (28, 47.5%). Thirty patients (50.8%) were referred to additional workup, 11 patients (18.6%) to a second opinion, and 25 participants (42.4%) were counseled to complete genetic sequencing or additional molecular profiles on their pathologic samples. Twelve patients (20.3%) were referred for pathology revision within our institution. Three patients (5.1%) had a change in treatment plan resulting from the clinic visit. The majority (90%) would recommend the patient-pathology clinic to other oncology patients.

CONCLUSION

To our knowledge, this is the largest study of patient-pathologist consultation services implemented at a single institution. Our work suggests that the program may provide effective patient understanding and reinforce the role of the pathologist as the patient's doctor. This work surfaced the concerns of patients, regarding their pathology reports, and demonstrated that the patient-pathology clinics are a valuable platform to address patients' distress regarding uncertainty of their diagnosis and an integral resource engaging directly with patients, driving additional evaluation and patient-targeted treatment.