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41. What’s the Basis for My Diagnosis?

Sometimes doctor’s are not positive about a cancer diagnosis, and will order additional tests to provide a better basis for their conclusion. Or, if the doctor is sure you have cancer, the patient still may want to obtain a "second opinion" about that diagnosis.

  • Questions...
  • A) Are you really confident I have cancer?
  • B) What kind of tests would make you more confident of a cancer diagnosis?
  • C) How experienced are the pathologists and can I get a copy of my slides?
  • D) Do you mind if I get a "second opinion" from another doctor?
  • Practical Tips...
  • Sometimes doctors are not sure. A "CT scan," for example could reveal a small nodule on the lung, say 0.5 millimeters (when Stage 1 lung cancer usually begins when a nodule measures at least 1.0 millimeters). So the doctor might request another CT scan in six months, and defer a conclusion about cancer until they see those test results. This type of process is sometimes called "watchful waiting."
  • One of the most common tests -- to verify that cells are cancerous – is a "needle biopsy," that involves insertion of a tiny needle into the place where a potential tumor may exist, and extracting some tissue in order to examine its cells under a microscope. This is not a general anesthesia operation.
  • Tissue extracted from a biopsy is transferred onto slides for microscopic analysis by experts known as "pathologists." Unless they are highly experienced, this is one place where a flawed diagnosis can occur. If you can, try to get a copy of your pathology slides.
  • When patients are diagnosed with cancer, many of them obtain a second opinion from another oncologist -- usually at a different hospital. Be mindful that this process requires forwarding of data by the original oncologist -- including pathology slides, and other test results.