The Leading Role of Pathology in Assessing the Somatic Molecular Alterations of Cancer

For nearly 30 years as a career pathologist I have seen it evolve to something that will eventually replace the human eye, from morphology to molecular pathology! Since the days of Virchow, morphology was once regarded as the “gold standard”, and I am so glad I got to train among the elite group of pathologists who valued morphology. I remember training at Emory where in those days special stains, immunostains and electron microscopy were the essentials to confirming diagnoses of deceptive cancer. Nowadays, pathology has become alphabetical and numerical soup – where genetic markers dictate the final diagnoses of cancer. Yes, it has made the day to day expense for patients — astronomical and near unaffordable for not only patients but also pathologists who own their practices even though pathologists simply send those samples out to academic centers and large reference laboratories, and patients absorb the expense for those services. To my dying day, I will always be a morphologist-based pathologist because at the end of the day – it saves lives and is pragmatic for everyday patients!

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