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November 2019 | Published by RCPA

Issue #097

International Pathology Day (IPD) 2019

International Pathology Day (IPD) 2019

This year, International Pathology Day (IPD) took place on 13 November. This is an initiative launched by the RCPA in 2012 to raise awareness of pathology in the community. To celebrate, the College hosted an event at their headquarters in Surry Hills, with a focus on human papilloma virus (HPV)-related head and neck cancer. The event was attended by guest patients Julie McCrossin AM, TV presenter and media personality and Archibald prize-winning artist Nicholas Harding who shared their personal stories with the disease.

During the event, anatomical pathologist, A/Prof Ruta Gupta, staff specialist in the Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, and Prof Jonathan Clark AM, head and neck surgeon and Director of Head and Neck Research at the Sydney Head and Neck Cancer Institute at Chris O’Brien Lifehouse, shared their professional insights into the disease. National medical reporter for the ABC, Sophie Scott, returned for a third year to lead the event’s discussions.

Speaking at the event, Associate Professor Ruta Gupta said,

“Head and neck cancers are very serious cancers but unfortunately are one of the most under-supported, under-researched and under-funded cancers worldwide. HPV-associated oropharyngeal cancers have about the same incidence as cervical cancers. However, currently there are no effective screening methods for the oropharynx cancer and it often presents with neck lump rather than symptoms related to the tonsil or tongue. Australia leads the world in HPV vaccination, and it was a Fellow of the RCPA who developed the vaccine. Since 2007, the vaccine has been part of the national immunisation programme for girls. In that time, the incidence of HPV infection of the cervix has gone down from nearly 23% to 1% in women. Since 2013, the vaccine has also been rolled out to boys. We are set to get ahead of cervix cancer by 2035. It is too early to examine the effect of the vaccine on oropharynx cancer, but hopefully it will be similar, but perhaps at a later date.”

Commenting on the importance of the multi-disciplinary team, Professor Jonathan Clark said,

“When we choose which patients to operate on, we do it as a team. The speech pathologist, the radiation oncologist, the medical oncologist, the dietician and the surgeon will all decide together, and the pathologist is so critical in that team. Pathologists play a very key part, not only in the diagnosis but for me as a surgeon they play a vital role in the assessment of the tumour after it has been removed. Together, we look at the success of the operation in terms of the number of lymph nodes that have been removed, how many are involved, or whether there is extension of the tumour along the nerves or into blood vessels. We also assess the primary tumour in terms of its growth pattern and its margins.”

In October 2017, Nicholas Harding was diagnosed with cancer at the base of his tongue. With a good prognosis, he commenced seven weeks of treatment at Lifehouse, finishing after 35 sessions of radiation and seven doses of chemotherapy. On his last day of treatment, he took a selfie during one of his regular sorbolene soaks and later drew a self-portrait from it, for which he became a finalist for the Archibald prize in 2018. Speaking about his experience he said,

“I remember very vividly when my Doctor told me I’d never be the same afterwards, but I felt very able to trust the process because I could gauge the quality of the people looking after me. For me it started with a scratchy throat which went away, followed by bad breath, but my GP suggested it could be hay fever. When a lump suddenly appeared in my neck, I went to another GP who was immediately suspicious and sent me for a biopsy. Pathology was therefore the end of trying to work out what was wrong, and I thank the pathologists for their hard work.”

During the event, Associate Professor, Bruce Latham, President of the RCPA, said:

“There is an increasing trend amongst the general public, and also amongst our colleagues, to not understand that pathology is a medical specialty. IPD is an opportunity to remind our colleagues that when they send tissue to a laboratory, it is looked at by a medical specialist. It does not go into a machine which prints out the answer. As we’ve said often before, 70 per cent of medical diagnoses, and 100 percent of cancers diagnoses, rely on pathology. What we as pathologists do is really important in a multi-disciplinary team.”

To view a video of the IPD event, visit: https://www.rcpa.edu.au/Events/PathologyDay/Watch-The-RCPA-IPD9-Event-Feat-Julie-McCrossin







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