International Pathology Day

[Doc Alan]

Today ( 5 November ) is International Pathology Day.





Pathology is vital for the prevention, early detection, diagnosis and treatment of many of the leading causes of disease.


Medically qualified pathologists, scientists and other laboratory professionals also play a vital role in public health - defining disease patterns in populations ; keeping cancer registries ; lowering rates of medical errors and infections ; improving overall quality of healthcare.


Pathology services provide most ( ¾ ) of all diagnoses used for clinical decisions, using only 2% of global healthcare spending. Diagnosis and treatment of disease across the globe depends on pathology !

Pathologists don’t work in isolation – but with teams of other health professionals including surgeons, radiologists, cancer specialists and nurses, to ensure treatment is correct for each patient.


Training to become a pathologist takes at least 12 years after leaving school - it involves becoming a doctor and then specialising in one of the many branches of laboratory medicine.


• Cellular pathology includes histopathology ( microscopic study and diagnosis from tissues – biopsies/samples, and surgically removed ) and cytopathology ( looking at cells, for example from cervical smears ).

A " test result " requires human skills, not just machines ! This forms the majority of most pathologists’ work and is needed for diagnosis, not only of cancers but also many other conditions ( including Rayna's gallbladder ! ).


• Post mortem examinations - a small proportion of pathologists' work ) are mostly for legal purposes but also to learn more about disease processes and establish cause(s) of death.


• Microbiology – infectious diseases ( diagnosis of tuberculosis, malaria, ebola and many others ).


• Haematology – blood diseases like leukaemia, and blood transfusion.


• Clinical biochemistry / chemical pathology – body chemistry like electrolytes, glucose for diabetes, and cholesterol measurements. These are done by machine but require human interpretation.


• Immunology – study and diagnosis of " host defences " ( antibodies ) which help in treatment and checking if vaccines have worked.


• Genetics – study of inheritance, chances of acquiring diseases and DNA analysis ( for clinical and legal purposes ).

[Abigail]

A very worthwhile profession indeed Doc and I for one salute them all. I just wish there were more of them and more funding to allow in depth studies of some or the less common conditions.

Happy Pathology day Doc

[Dedworth]

That's interesting Doc thanks - I might not be interpreting it correctly but are you saying specializations such as Microbiology, Haematology, Immunology are branches of Pathology ? How about virology ?

[Doc Alan]

Thank you Abigail and Ded !


Of all the doctors on the Specialist ( non GP ) Register of the GMC, a minority are pathologists. Most are histopathologists ( 2000+ ) - making clinical diagnoses by microscopy ; with[ rather fewer haematologists – diagnosis and treatment of blood disorders, and transfusion.


There are in fact many specialties within pathology. Apart from the ones listed already, these do include medical virology ; forensic pathology ( the only specialty where post mortems form a large part of workload ) ; paediatric pathology ; neuropathology ; and veterinary pathology ( non medical ).

[Doc Alan]

This Wednesday ( 18 November ) will be the second International Pathology Day and I’m looking forward to taking part in the London conference celebrating the vital role of pathologists in global health.



All members who may have read any of my posts might appreciate the influence of pathology on almost every aspect of health - and the need for those medically qualified pathologists, scientists, and other laboratory professionals to keep up to date.



International Pathology Day is supported around the world - from Europe to Africa, Australasia, America and Asia ; including Hong Kong and Malaysia, but not ( so far ) Philippines. There IS a Philippine Society of Pathology which sets high standards and has 600 members. The UK Royal College of Pathologists has about 9,500 UK members and 2,500 overseas members.



What does all this matter to Forum members and the general public ? Hopefully no-one on the Forum will now think that if they or their loved ones are ill, " test results " come back from the " path lab " showing " cancer ", " infection ", " all clear " or any other answer, without knowing that the " tests " require highly skilled interpretation ! Your own doctor also has to interpret and act on the results depending on all the knowledge he/she has about you and your health.



The myth that pathology is only about " chopping up bodies " and investigating suspicious deaths should also be understood ! This is a vital part of pathology, but only a small number of pathologists actually perform post mortems ( including cases where there was uncertainty about illness(es) during life which might have affected treatment and could help future patients ).



Pathologists are involved with diagnosis of disorders affecting every organ of the body, from before birth to after death. The subspecialties of pathology are listed in post #1 in this thread. It has never been more important for pathologists around the world to exchange knowledge - from diagnosing and treating communicable diseases like malaria, HIV/AIDS, TB and Ebola, to advances in non-communicable diseases - like early diagnosis of heart attacks and strokes, and research into mental illnesses - like dementia.



I wish I could say all was well with the UK NHS, and Philippines health services - but NO country in the world comes out top with every aspect of their health systems.



Thankfully I still have the interest ( and, so far, good health ) to support younger colleagues and friends in pathology both in the UK and elsewhere, as well as Forum members. Wherever you live or intend to live, good health to you all .

[Doc Alan]

For the few members who may be interested, this was a truly international meeting covering a wide range of topics, with around 100 delegates from many countries taking part.

Highlights :-


* The UK Royal College of Pathologists helps training, setting standards and examinations in a range of centres in the Middle East, Africa and Asia. Facilities and personnel which we take for granted in the UK may be minimal or non-existent in other countries.

Examples:- fevered patients may be treated for malaria without confirming the diagnosis, so other causes of fever may not be treated until it’s too late ; breast cancers may not be treated properly because tests to identify their types are simply not done ; rapid, cheap testing for a range of illnesses from TB to cervical cancer may also not be done.


* Terrorism is a worldwide challenge. " Plan Orsan " addresses incidents in France with a large number of casualties ; a week ago over 80 people needed emergency treatment and emergency response teams were quickly at the scenes. Health professionals are needed wherever such incidents and fighting occurs ; transfusion medicine is one of the essential pathology specialties in these circumstances.


* Antibiotic resistance is another worldwide challenge. Up to half of all antimicrobial drugs may be unnecessary ; " over-the-counter " sales without prescription are a problem ; use in animals contributes to resistance ; vaccines are only part of the solution ; TB ( with or without HIV/AIDS ) is a major global contributor to ill health and multidrug resistance an increasing worry.


* The challenge of preventing future pandemics is a third worldwide problem. Ebola virus disease in West Africa was simply the latest - cheap rapid testing and development of treatments and vaccines are all the concern of pathology specialties.


* Climate change and extreme weather events are a fourth worldwide problem - typhoons in the Philippines required skilled health professionals including those in pathology specialties with experience of preventing / treating likely illnesses.


* Telepathology - where countries lack pathologists, " remote " diagnosis of cancers and other conditions is developing, as it becomes easier to transmit large amounts of data from microscope slides through the internet. The samples still need to be processed locally, then scanned for transmission to pathologists. These include blood disease specialists / haematologists for , say, leukaemia ; and other disease specialists / histopathologists for , say, cancers ).


* The specialty of microbiology is involved in diagnosis of infections, and identifying new ( or under-diagnosed ) conditions.

Example :- viral hepatitis E is an illness of the liver which can infect both animals and humans. It’s now the commonest type of hepatitis - although most people fully recover, it's a threat for those with poor immunity ( HIV/AIDS, transplants ) and pregnant individuals. So far there’s no licensed vaccine. Most UK pigs are infected - another reason meat / meat products need to be thoroughly cooked.



* How does an International Pathology Day benefit UK citizens / patients ?

Nobody wants epidemics and we need to reduce risk of pandemics such as HIV/AIDS and influenza. The most likely future risks are from animal diseases spread to humans - we need to be prepared but can't predict the next pandemic with certainty.


If they had insight into standards of healthcare in many other countries, including the Philippines, they might appreciate the NHS, despite its many problems ( the only one concerning and understood by the Government being financial ).

Pathology is involved in 70% of all diagnoses, and needed ( but sadly lacking ) worldwide for treatments to be effective.

[mickcant]

Very interesting Doc.
Mick.

[Michael Parnham]

Missed this earlier in the Month Alan, very interesting, good one!

[SimonH]

Was this held at The Royal College of Surgeons, at Lincoln Inn Fields?

[Doc Alan]

Thank you Mick, Michael and Simon .


The symposium was held at the King’s Fund, London ; organised by the Royal College of Pathologists ( RCPath, founded in 1962 ; separate to the Royal College of Surgeons ). There was a wide range of delegates who were hopefully inspired to a better understanding of the crucial role of pathology in global health .


RCPath is concerned with the science and practice of pathology ( 19 different specialties ), including scientists and medically qualified pathologists - mostly from the UK but also from overseas. Membership by examination is a requirement for UK pathologists.


Without pathology, much of the NHS would grind to a halt ; anyone who has a blood test, cervical smear or tissue biopsy has a pathologist involved in their care ; over 800,000 tests and 120,000 post mortems are done each year in the UK. Sadly the standards set by RCPath and similar organisations are not ( yet ) reached in many parts of the world.

[Arthur Little]

Once, again, Alan ... a really enlightening write~up.

Indeed, I'd been going to say what nice photos accompanying it too. But, of course, I notice you've since "excised" those from view! And then ... it suddenly occurred to me, that the first of the two ladies may, perhaps, have been afraid she'd give the impression of appearing a "cut" above the rest of the Conference Delegates - being the President - while the second, as the journalist assigned to report on the Symposium (Tulip) was, I would venture to suggest, very aptly~named ... with her "two lips" readily poised for the purpose.

[Doc Alan]

Thank you, Arthur . I don’t need to self-promote ( my posts are to inform any interested members ) - but I will re-attach the photos for now, to explain YOUR post !



Dr Lishman is at the " cutting edge " of pathology - youngest president of our college and only the second female. Not only does she inspire as a leading public face of pathology but she also continues with diagnostic work at Peterborough City Hospital :-







Tulip Mazumdar is BBC health correspondent who led news coverage of Ebola epidemic ; she is of Indian Bengali descent, and from Spalding, Lincolnshire ; her first name " sprang " to mind as her mother looked out on tulip fields :-