Understanding Your Diagnosis
ASK Your Doctor: Understanding your Diagnosis
Initial Diagnosis
Think of "Diagnosis" as a tree. As an example, "Lung cancer" is the trunk, “non small cell” (NSCLC) or "small cell" are example branches of that tree. As you travel up, “adenocarcinoma” is a fork in that branch, and this may be the extent of detail a traditional Diagnosis analysis identifies.
BUT, you will want to explore further up into the canopy of your diagnostic "tree" following the branch forks until you identify your unique “leaf”. That “leaf” is your specific lung cancer genetic mutation or aberration. These "leaves" are specific cancer signatures; examples of a few such lung cancer mutations are EGFR, ALK, ROS1. Traditional Diagnostic analysis does NOT drill down to this level of genomic specificity. Specific mutation identification is described in another section under the genomic testing (GCP) description.
Initial Biopsy
A biopsy is the removal of a small piece of the tumor tissue itself. The biopsy is sent to the Pathology department to identify "what is this?" The Pathology department will do an assessment to identify " what is this?" A biopsy gives more information than your initial scan which first identified a potential tumor.
Using the diagnostic “tree” analogy, this technique is used to identify the “branch” of your disease description.
A more extensive pathologic analysis will likely be done once more tumor tissue is captured to understand the extent of the tumor and further validate what type of tumor and subgroups make up this tissue sample. This subject will be further detailed in the third section of ASK Your Doctor.
Staging
Staging helps describe where a cancer is located, if, where and how much it has spread, and whether it is also affecting other parts of your body. T(X), L(X), M(X) - T: Tumor extent, L: Lymph nodes, extent tumor present, M: Mutation to other sites. These tumor feature designations are a key factor in determining what treatments the doctor will use, how your cancer will be treated, how it will likely be and how aggressively it will be treated.
Questions to Ask your GP or Organ Specialist
1. What disease do you suspect this to be? Please explain.
2. Where is it located and how far has it spread?
3. Will you be taking a biopsy?
4. What is the next step in my work up?
5. What role will you play going forward in my care?
Will you be consulting with an Oncologist about my case?