Pathologists are core members of the cancer multidisciplinary team (MDT). At a local level, the pathologist’s role is to provide information for the MDT on the results of biopsy and specimens after surgery. Pathologists can report if cancer is present and then whether the cancer has been successfully removed – this can influence the need for adjuvant therapy.
Arguably one of the fastest ways to improve cancer outcomes is to insist on full reporting of all cancer cases – from diagnosis to death, so that we can better understand current trends, successes and challenges. Pelican has worked closely with Professor Phil Quirke from Leeds on a number of projects to develop cancer reporting. Professor Quirke’s objective is to improve outcomes for cancer patients and to focus on areas where we can make the greatest gains in colorectal cancer. To achieve this, he is sometimes provocative in his statements – for example, here in the journal GUT.
It is only by collecting full and up-to-date data for cancer that we can firstly understand the current situation – our benchmark – and then improve on it.
Over the last five years the Royal College of Pathology has carried out extensive audits and updated protocols so that there is consistency on colorectal cancer reporting.
The most recent work undertaken, in conjunction with CRUK and NCIN, showed the 30 day survival after colorectal cancer surgery. Whilst many centres were upset about the results of this paper, it provides transparency, and demanded that all centres look closely at their results and consider if improvements could be made.
Interestingly, one trust stood out with an exceptionally low mortality rate. When closely investigated, the difference that Mike Parker, President of the Association of Coloproctology of Great Britain and Northern Ireland, could identify was that they were ‘optimising every area of standard practice within a mutually supportive team that communicates well’.