Real-Life Decision Making -- Solution
You tell the pathologist.
This is the real-life decision made by cytotechnologist Beth Gardino Walsh. "Inexperience often leads to a slight lack of self-confidence," she says. "But we run into differential diagnosis problems almost every day."
You show the slide to several co-workers, who agree that the cells look like they may have been caused by bladder cancer. Encouraged, you turn to a reference manual. You find several articles outlining the difference between the two cancers, and the way that each should be treated. More than ever, you realize it is important to diagnose the patient with the correct kind of tumor.
Screwing up your courage, your write up a diagnosis that considers the possibility that the patient may have either bladder or prostate cancer. When the pathologist reads your diagnosis, he decides to take another look at the specimen on the slide. He agrees that it is difficult to tell what type of cancer caused the malignant cells to appear in the patient's urine.
Working together, you examine a previous biopsy of the patient's prostate. There is no doubt that the malignant cells that showed up in the urine look similar to those found in the prostate. Still, the pathologist decides to perform a special type of test that will conclusively diagnose what type of tumor is in the patient's prostate.
The tests prove that you were right. The patient had bladder cancer, which had spread to the prostate. You feel good that you helped correct a faulty diagnosis. The experience increases your self-confidence, and teaches you to trust your own instincts.