Pathology is for the living too

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The first ever National Pathology Week is taking place from 3 to 9 November.

Here, Dr Karin Oien, Clinical Senior Lecturer in Molecular Pathology at the University of Glasgow, explains that the subject is not just about dead people. <hr />When you hear the word "pathologist", do you immediately think, "there's been a murrr-durrr"? If so, then you're in good company: 60% of the UK population think that pathologists deal only with the dead.

Dr Karin Oien specialises is histopathology and cytopathologyBut in fact only around a quarter of medically-qualified pathologists perform post-mortem examinations; and for most of them it's only a small part of their daily work.

Instead, pathologists make a huge, and largely unsung, contribution to the care of living patients. Pathology means "the study of disease": its causes, mechanisms and effects: so it is the lynchpin of medicine as a whole. Pathologists provide over 70% of diagnoses made in NHS patients and their advice influences the treatment of many more.

All of this is achieved through laboratory tests on samples from patients. If you've ever had a blood test, cervical smear or tissue biopsy, the result will have been provided by a pathologist. Millions of pathology tests are performed annually: an average of 14 for every man, woman and child every year.

Spending on pathology accounts for nearly £4 billion, that's 4% of the NHS budget.

There are eighteen pathology specialties. The main ones will be familiar from hospital dramas: haematologists deal with diseases of blood and bone marrow, such as clotting disorders and leukaemia; chemical pathologists (biochemists) study abnormalities of the chemical composition of body fluids; and microbiologists deal with infections, including the increasing problem of antibiotic resistance.

Genetic diseases

Amongst the rarer specialties, forensic pathologists are in fact the ones who deal mainly with the dead: they aim to find the cause of death in medico-legal cases.

Immunologists study immune diseases such as rheumatoid arthritis and allergies. Geneticists diagnose and study genetic diseases: it is geneticists who analyse amniocentesis samples taken during pregnancy.

My own specialty is histopathology and cytopathology. We deal with cell and tissue specimens, from cervical smears, needle samples from breast lumps and small skin or endoscopic biopsies through to the appendix, lung or bowel obtained at surgery.

Pathologists can help identify diseases like cancerExamination of the appearance of the samples by naked eye and using a microscope yields a huge amount of important information.

For example, in a case of breast cancer, the pathologist can not only make the diagnosis but also determine whether the main tumour has all been removed, how far it has spread and how aggressively it is likely to behave.

Extra tests looking for specific marker molecules can tell us what anti-cancer treatments are likely to be successful.

You can see that although pathology is also called laboratory medicine, for good reason, the tests which we perform and interpret are vital for patients.

And although most pathologists who work directly with patients in clinics or on wards are medical doctors, most of the 30,000 staff in pathology departments UK-wide are in fact highly qualified scientists, technicians or administrators.

We are telling you this because the first ever National Pathology Week is running from 3-9 November 2008. It is being organised by the Royal College of Pathologists and other specialist societies to promote pathology.

Public events

More than 150 free events are being held in hospitals and communities throughout the UK and include interactive workshops, laboratory tours, art competitions, quizzes and even a touring pathology bus.

In Glasgow, we are delighted to have the opportunity to show the public what pathologists really do. On 3, 4 and 5 November there are open days with demonstrations for local schools, medical students, staff, healthcare professionals and the general public. In addition there are two public lectures.

On 3 November, Professor Jim Cassidy explains the cancer specialist's view of the impact of pathology on the management of cancer patients.

On 4 November, Professor Naveed Sattar describes the role of chemical pathology in improving the health of patients with diabetes.

All of these events are held in the Wolfson Medical Building at the University of Glasgow and no booking is required.

Scotland's universities have played an important role in the development of pathology through the teaching of young doctors and scientists and through research. Currently our efforts are to improve how we care for patients by identifying better specific marker molecules and treatments for many diseases.

In cancer, this research is vital if we are to improve patients' outcomes and experiences. To achieve this, we aim to build a dedicated Beatson Translational Research Centre here in Glasgow to develop better disease markers and therapies. A £10million Pebble Appeal public campaign has been launched to support this effort.