Diagnostic oncology: role of the pathologist in surgical oncology--a review article

The practice of surgical oncology requires a multidisciplinary approach involving the pathologist, surgeon, clinicians and other workers. The task of a pathologist is to provide adequate, and accurate diagnosis sufficient for the clinician to take decision for patient management. In the tropics, the practice of pathology is seriously challenged by infrastructural decay and in most cases clinicians rely on their clinical skills for management of cancer patients. With tremendous advance in the field of oncology, the diagnosis of cancers involve the understanding of biological behaviour of the cancer. The details of type and origin of the tumour, its differentiation, level of invasion, the number of lymph node(s) with and without metastasis, the presence or absence of receptors for hormones, activity of enzymes, ploidy, frequency of mitosis and percentage of cells in the S-phase may all be relevant in the pathological assessment of neoplastic tissue. The use of molecular biology has also enhanced our understanding of the neoplastic process. Examples include the use of nucleic acid probes with or without amplification, polymerase chain reaction to detect expression of specific tumour genes or gene mutations, but these have not yet become standard practice in this environment. The review is aimed at highlighting the role of the pathologist in the management of cancer.