That's an eye-opener! Thanks for posting it.

Very, very interesting article, and well worth the read. Thank you for posting it! A dear friend of ours recently had a brain scan done and a tumor was found. He's having it operated on tomorrow in a local hospital. I shudder to think of this, and just don't understand why he wouldn't go to a more well known cancer facility for a second opinion BEFORE operating. I know I would, even if I had to mortgage my house again to pay for it!

I hope everyone will pass the link on to someone they know.

Nanny, sorry about your friend. Are you comfortable printing the article out and bringing it to them? I printed it out for a neighbor & left it in her mailbox today for her MIL who was just diagnosed with lung.

I'm sure everyone remembers me second guessing where hubby was going to be treated; it still makes me hyperventilate some days!

After reading the article, I'm glad that I said no to the local biopsy because they mentioned that too that some are not competent to give a good pathology report. (page 3)

A few interesting parts

With a slim, otherwise healthy man with testicular cancer, he explains, it's easy to remove a dozen lymph nodes (to check for metastasis and therefore the need for chemo and radiation). But in a 300-pound man with fat everywhere, lymph nodesand therefore metastasiscan be missed, with consequences that can be fatal.

Another good part - page 3 talks about misdiagnosis

Another caveat is that to know which cancers can be successfully treated in a community setting, you must have an accurate diagnosis. Here, unfortunately, the disparities between elite cancer centers and everywhere else can be stark. "About 75 to 80 percent of cancer diagnoses can be done correctly" in settings outside specialized hospitals, says Thomas Burke, physician in chief at M.D. Anderson. He estimates that patients traveling to M.D. Anderson have an incorrect diagnosis from a community pathologist about 5 to 10 percent of the time. Although many of those patients have rare cancers that pathologists have little experience with, some have all-too-common ones. A woman in a small town in Texas recently called Raymond DuBois, executive vice president of M.D. Anderson, after being diagnosed with an eight-millimeter ductal carcinoma in situ, a treatable form of breast cancer. DuBois said it never hurts to get a second opinion, and referred her to an M.D. Anderson oncologistwho determined that she actually had a five-centimeter breast tumor that required "much different treatment than what they were planning," says DuBois. "She required total mastectomy, radiation, and adjuvant [chemo] therapy. I think we saved her life." When it comes to outcome disparities, he says, "diagnosis is where the biggest problem is."

That has long been recognized as the weak link in cancer treatment. As far back as 1997, scientists at M.D. Anderson examined pathology reports for brain and spinal-cord cancers in patients who had been diagnosed elsewhere, mostly in community hospitals. Of 500 cases, there was serious disagreement (meaning it had significance for what therapy the patient should have) in 44, and substantial disagreement (affecting the type or grade of tumor) in another 96. The scientists called these "clinically important diagnostic errors."

"Little delays with a nonaggressive cancer might not matter, but a two-week delay with an aggressive cancer can mean the difference between life and death."

At M.D. Anderson, the breast-cancer department alone has 24 medical oncologists, 13 surgeons, seven radiation oncologists, 16 radiologists, and 13 pathologists. "For every new case, 24 medical oncologists sit around the table and discuss it," says Jennifer Litton, one of the 24. "That's 23 second opinions straightaway."

Thanks for the article. We attended a dear friend's memorial a week ago. He died of pancreatic cancer - just one month and two days after the proper diagnosis. He was being treated for indigestion and was only 52 years old.
Our kids grew up together and played on the same traveling soccer team for many years so we spent lots and lots of time together. I know pancreatic cancer is not a good cancer to have but the delay in diagnosing certainly did not help.

Today I heard that obesity is responsible for many cancers... One more reason to watch our food intake (sigh).

My memory is fuzzy so I'm trying to summarize these studies. If someone is sitting there with a copy, I may be wrong on some details.

Five to six years ago, POG (Pediatric Oncology Group) published a study that showed a lower percentage of minority children recovered from pediatric cancers. St. Jude turned around and immediately published their own study, countering those claims. St. Jude's statistics show very little difference in outcomes between racial groups. In fact, African-American children fared slightly better than any other group. The difference is that every child at St. Jude is treated individually. Following the statistics were interviews from various doctors basically stating (here is where I paraphrase) ... it's not the child, it's the hospital. Children who have access to better medical facilities fare much better. And those facilities do not have to be St. Jude, but they need to be facilities that specialize in cancer. I'm not surprised to find that adult cancer outcomes follow the same pattern.

Interesting discussion.

True outcomes can be different from hospital to hospital and physcian to physician. That's why I always stress to friends and family to get 3 opinions on everything.

If you need a biopsy, you can always request an outside consultation with a pathologist in a hospital of your choice, if the outcome is cancer. Hopefully, in-network.

There are some hospitals that have very strong pathology groups that are not cancer hospitals. Example, Cooper Hospital in Camden, NJ (one cities for crime but I would say one of the best in NJ) has a group that is just as strong if not stronger than some of the Phila hospitals. Fox Chase Cancer Center has some of the best in the country.

If someone you know has cancer, make sure they have a copy of their pathology report and their xrays (if there are any). If they are getting another opinion from either an oncologist or pathologis, they will also need some of their pathology slides. Request these and have them sent to the physicians you are seeing ahead of time so they can either have them reviewed or send them to be reviewed.

Biopsies are very important. It prevents unnecessary surgeries.