Oncopathology has emerged as one of the most important aspects of cancer treatment, doctors and experts said.
Oncopathology or cancer pathology is a specialised branch of pathology focused on diagnosing and characterising tumours. It involves examining tissue samples, cells, and bodily fluids to determine if cancer is present in a person. If detected, then its type and grade are determined. This information is crucial for guiding treatment decisions and predicting patient outcomes.
The latest advancements in oncopathology — which can help in widening the ambit of targeted therapy — were discussed at a training programme hosted by a city-based hospital last week.
“Modern screening methods can now enable a breast cancer patient with a relatively lower HER2-positive score to undergo targeted therapy. Previously, only patients with a high HER2-positive score were selected for targeted therapy. The rest had to undergo chemotherapy, which kills not only cancer cells but also good cells,” said Tanuja Shet, head of the department of pathology at Tata Memorial Hospital in Mumbai, who was at the programme.
HER2 is a gene that plays a role in normal cell growth and division. In some cancers, particularly breast cancer, the HER2 gene can be amplified, meaning it can promote faster cancer cell growth and potentially lead to more aggressive tumours. If HER2 is blocked by a drug, the cancerous cell dies. Patients live longer because there is no more cell proliferation.
Targeted therapy is a type of cancer treatment that specifically targets molecules involved in cancer cell growth, division and spread.
“Earlier, we used to look at amplified HER2 only (for targeted therapy). Now, there are drugs for patients with low HER2 levels as well. But for that, proper screening is a must,” Shet said. She was in Calcutta for the programme at Narayana Health Cancer Centre and RN Tagore Hospital on Friday and talked to Metro on the sidelines.
Devmalya Banerjee, consultant lead oncopathologist at Narayana Health Cancer Centre and RN Tagore Hospital, said more than 35 pathologists from Calcutta attended the programme, alongside surgeons and medical oncologists.
“There are clear testing and treatment guidelines laid down by the ASCO/CAP (American Society of Clinical Oncology/College of American Pathologists). The purpose of the programme was to familiarise the local pathologists with these guidelines,” he said.
Ang Peng Tiam, medical director and senior consultant at Parkway Cancer Centre in Singapore, who was in Calcutta last week, had told Metro “oncopathology is the cornerstone of cancer treatment”.
“Everything depends on fast and accurate diagnosis,” Tiam had said.
Gautam Mukhopadhyay, clinical lead, department of surgical oncology, Narayana Health Cancer Centre and RN Tagore Hospital, echoed him.
“Detailed biopsy reports now come with various markers, including immunohistochemistry (a technique used to detect specific proteins in tissue samples) and molecular genetics. That helps in treatment. The more accurate the report, the better the treatment. Cancer treatment is largely dependent on the oncopathology report,” said Mukhopadhyay.