Sylvester Pathologists Help Patients Understand Their Cancer Diagnoses
A new pilot program at Sylvester is connecting patients directly with pathologists to help them navigate complex pathology reports and reduce anxiety.
Historically characterized as the “doctor’s doctor,” pathologists have worked closely with their medical colleagues behind the scenes, providing detailed insights into disease processes that help guide patient care. Despite their critical role on the care team, they are specialists who are not typically patient-facing.
A new pilot program at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, is changing this dynamic. The “Doctor’s Doctor IS the Patient’s Doctor! A Patient Care Quality Improvement Study” connects patients directly with pathologists to explain complex pathology results in a way that fosters understanding and reduces stress.
“As molecular diagnostics and therapeutics grow more complex, this program allows us to step out from behind the scenes and educate patients directly,” said Carmen Gomez-Fernandez, M.D., senior pathologist on the study, professor of pathology, vice chair of education and trainee mentoring and co-director of the breast pathology service in the Miller School’s Department of Pathology and Laboratory Medicine. “We’ve always educated the care team, who then explains the diagnosis to the patient. Now, we’re delivering that expertise straight to the patients, providing them the opportunity to discuss their diagnosis with the doctors who are responsible for making them.”
This program has become even more essential following the 21st Century Cures Act, which grants patients immediate access to their pathology results through electronic portals. With complex medical language at their fingertips, many patients turn to the internet for answers before consulting their doctors, often leading to misinformation and unnecessary anxiety.
Simplifying Complex Diagnoses
The pilot program focuses on breast pathology, both benign and malignant, using a multidisciplinary approach. Radiologists and surgeons offer patients the option to review biopsy results with a pathologist, and about half of them typically accept.
While in-office consultations are available, most patients prefer telehealth, allowing them to discuss their pathology results from home in English or Spanish. During these sessions, pathologists carefully review the pertinent biopsy findings that will determine the patient’s prognosis and direct their subsequent management.
This approach provides deeper insights without replacing discussions with other specialists. Patient feedback shows reduced anxiety, increased empowerment and clearer understanding.
“The visual presentation gives context to the technical details,” said Katherine Drews-Elger, M.D., Ph.D., chief pathology resident at the Miller School, who has been working on the project. “We simplify complex diagnoses based on each patient’s unique case, clearing up confusion and addressing concerns. This helps patients make more informed decisions when discussing treatment with their care team.”
A Multidisciplinary Approach
The process has benefited both patients and radiologists. Jose Net, M.D., director of breast imaging services at Sylvester and associate professor of clinical radiology at the Miller School, said that while he can provide general explanations, pathologists are key in answering more specific questions, such as the reasoning behind a diagnosis.
“The Cures Act often overwhelms patients with information they’re not equipped to process,” said Dr. Net, who is collaborating on the project. “When specialists communicate directly with patients, they can break down complex language into clear, accessible terms. This empowers patients to take a more active role in their care.”
Monica Yepes, M.D., a Sylvester radiologist and professor of radiology in the Miller School’s Division of Women’s Imaging, agrees that clear, direct communication helps patients better understand their diagnosis.
“Some patients want to do a deep dive into their diagnosis and are often terrorized by what they read on the internet,” said Dr. Yepes, who is also collaborating on the project. “We welcome the extra support from pathologists who can answer patient questions about their diagnosis, leaving them with greater peace of mind.”
Providing Patient Tools for Decision-Making
Beatriz Londono was diagnosed with breast cancer in 2020. Like many, she turned to the internet to interpret her biopsy results before consulting her doctor.
Guided by her family history and doctor’s advice, she opted for the most aggressive treatment: a double mastectomy. Years later, she had an opportunity to meet with Sylvester’s pathology team to review her slides and better understand her diagnosis.
“The pathologists used simple language and vibrant images to explain the slides, giving me a far clearer understanding of my results,” said Londono. “The conversation reassured me that I made the right decision. This program is invaluable, and I would highly recommend it to any patient.”
In March, Sylvester’s pathologists will present their results at the United States and Canadian Academy of Pathology (USCAP) national meeting, the largest gathering of pathologists worldwide. This prestigious event showcases research and fosters collaboration among professionals in the field.
“We’ve had tremendous success with this project and are excited to share our results with other cancer centers that may want to adopt it,” said Dr. Gomez-Fernandez.
While the project is currently focused on breast patients at Sylvester, Dr. Gomez-Fernandez is hoping to expand it to all site disease groups.
Susan Kesmodel, M.D., director of breast surgical oncology and associate professor of surgery in the Miller School’s DeWitt Daughtry Family Department of Surgery, says the project exemplifies Sylvester’s collaborative, patient-centered approach to cancer care.
“Our model at Sylvester is to provide comprehensive, patient-centered care from a multidisciplinary team of specialists,” said Dr. Kesmodel, co-leader of the Breast Site Disease Group at Sylvester. “This is another example of how our collaborative approach can improve a patient’s understanding of their diagnosis and allow them to participate fully in the decisions regarding their cancer care.”
Tags: Department of Pathology and Laboratory Medicine, Dr. Carmen Gomez-Fernandez, Dr. Jose Net, Dr. Monica Yepes, Dr. Susan Kesmodel, pathology, Sylvester Comprehensive Cancer Center