NCCN Guidelines for Patients
: Caring for Adolescents and Young Adults
Part 2: Dealing with the diagnosis
be answered by other members of the doctor’s team
(nurse practitioners, physician assistants, and other
The pathology report
The pathology report is written by a doctor for a doctor,
which can make it a bit of a challenge for patients to
understand. Don’t be afraid to ask your doctor questions.
The report will cover everything from your name, age,
and other details on who you are (check this carefully!) to
details on how the biopsy sample looks, how the cancer
seems to be growing, and what it’s likely to do.
One of the most important items in the pathology report
is information on the sample’s tumor margins. When
evaluating the biopsy samples the pathologist will
examine the outer edges of the tissue to see whether
cancer cells are present. Samples that have no cancer
cells at the edges are considered to have negative
margins, which may mean the surgeon may have
removed all of the cancer. Samples that have cancer
cells at the edges are said to have positive margins,
which may indicate that cancer cells are still present.
Staging is a sort of shorthand designed to quickly
summarize the extent of a person’s cancer. Your doctor
will use information about the stage of your disease to
determine your prognosis (the likely course the cancer
will take) and to choose the best treatment for you.
The stage of the cancer may be expressed in several
different ways. One approach is the summary staging
system, which groups cancers based on their location
in the body:
Carcinoma in situ
is limited to the layer of cells
where it began.
is limited to the organ where
When all of your test results are in, your doctor
should go over them with you in detail. The questions
below can serve as a guideline to help you fill in any
gaps as you talk with your doctor.
What type of cancer do I have?
How aggressive is it?
Have any cancer cells traveled away from the
original tumor? Are lymph nodes involved?
Were any of the results unclear, and if so,
should the tissue be retested?
Do I need more tests to tell whether the cancer
has traveled to other parts of my body?
Questions to ask your doctor about: