Receiving a cancer diagnosis is scary. It can feel like there are an endless number of unknowns, from the general question of “how bad is it?” to what your treatment and care will look like, to what your life will look like as a survivor.
A cancer diagnosis 10 or 20 years ago left a lot of these questions unanswered, but advancements in cancer screening, diagnosis, and treatment have been able to drastically transform unknowns into knowns. The medical laboratory is central to providing those answers.
Pathologists and medical laboratory scientists play a unique but essential role in cancer care — we are the ones who run the tests that screen and detect the indicators of cancer. We are the ones who confirm the diagnosis with your primary care physician, who collaborate with your oncologist to establish the right course of treatment at the right time that is right for you.
To ensure patients are receiving the highest quality care, the pathology and medical laboratory science community continually works toward advancing diagnostics in four main areas.
Screening
You’ve probably heard of molecular diagnostics, or molecular testing, which is the analyzing the genome for biological markers that may indicate a medical issue. Molecular testing has become an essential part of practice in pathology and laboratory medicine, and in some cases it has paved the way for new screening approaches such as for human papillomavirus (HPV) or colon cancer.
These advancements are available now, but they’re also paving the way for future screening tests for 20 to 50 different types of cancers using samples of blood or stool, which can mean earlier detection and treatment for patients.
Diagnosis
Along with molecular testing, genetic sequencing — and direct sequencing of tumor variants — is quickly becoming the standard of care for patients with a new cancer diagnosis. Your tumor variant may mean a different prognosis or a different sensitivity to a potential treatment. These new tests enable us to diagnose cancer on a more personalized level.
Treatment
Prognostic testing — performing a test specifically to determine if a patient can receive a certain drug — has been a mainstay in cancer treatment, but in the past five years its use has revolutionized cancer care. Pairing prognostic testing with specific cancer therapies can better target a patient’s tumors and potentially provide a better outcome.
Post-treatment surveillance
Once a course of cancer treatment is completed, patients continue to be monitored to determine if the treatment was successful. The laboratory has helped advance this standard of care, using high-sensitivity molecular testing that pushes the boundaries of the limits of detection. This can help determine if the cancer has returned or spread.
The technologies used for screening, testing, and treating cancer are evolving rapidly, but the laboratory remains the central core of each new test. The screening, testing, and diagnosing we do as caregivers is essential both for patients and for the transformation of cancer care now and in the future.