So real 😂

I'm a histotech! Love seeing love for my pathology peeps

@@leahg.3393 ayeee that's awesome! Thank you for the amazing work you do :)

It’s incredible!

My aunt works in pathology too, idk if she does this stuff, but she did the thing for cancer (I have no idea what to call it) to my mom's thyroid because she had thyroid cancer, and my gallbladder when I got it removed. I find it pretty cool what she does but I could never

I’ve always loved and admired the lab and pathology! As a registered nurse, thank ALLL OF YOU !

❤

I hope you're doing well!

Agreed 😂

Oops 😂

I was a scrub nurse in theatre and I went one in pathology to look at how you handle frozen specimen, very interesting ! Thanks for your hard job

Thank you!! 😁

Literally, or the oops we cannot do anything hehe! Bye!

LITERALLY happened with my mother back in October

The accuracy....😊

Cancer is a hard thing to cure and fix, it’s amazing we even have these surgeries.

In a mini cupcake

Yep!

Histopathologist here! In this video the surgeon is resecting a tumour they know to be cancer but it's not entirely clear just from looking at the mass if they got it all out or is some still left in the patient (is the margin clear?) Doing a frozen might help - take a sample of the margin to make sure there is no cancer in it, that you've taken the tumour out and not left a little bit behind that you can't necessarily see. Frozens really are only for intraoperative patients where the result is actually going to affect immediate management (is this a parathyroid gland or not? Is this margin positive? Is this a metastasis to the liver in which case we should stop this surgery?). In my country, the target turnaround time for the specimen getting to the lab to a final report getting to the surgeon is 20 minutes. Why don't we do this for everything that comes to the lab? 1 - it's a big burden; the reporting pathologist, the lab scientists etc. all basically drop everything to get it done and 2 - it's not as accurate as a properly processed specimen. These take longer (couple days at least) but we can be reassured that the result is more likely true and accurate Most cancer surgeries don't need frozens (the tumour might be obviously all completely removed and well away from the margin for example) The rest of the tumour that gets cut out? That gets sent to Path too! We fix it in formalin, then carefully dissect it to make sure that we accurately represent it on microscope slides (make sure we can be confident on the diagnosis, grade and subtype) and check all the margins again. Those samples all get processed and stained (takes about a day or so) and looked at. We then might need to do extra stains or tests based on what we see or do genetic tests because they affect treatment, prognosis or because we need them for the diagnosis. All in all, you're looking at about a week from when the tumour is cut out of the patient before the final report, including diagnosis and stage and margin status is complete

​​@@TheKingBigfootso they cut the surface of the whole area that is removed? As in like the whole margin of where the tumor was/ located? Also, if it's not clear where the tumor is, is it possible to cut the wrong area and have negative margin results?

You can’t see it. We found ways to be able to match medicine and science to get best results. We won’t stand a x-ray machine on life above a 6hour operation table to cut 1200 tumors a year. We would all die. This is the safest way to see/know if the procedure is doing great without causing these kind of problems. Otherwise you can’t tell the difference between cells that are slowly merging into death. Everything has a price.

@@TheKingBigfootthank you this was so helpful and informative :)

@@SadisticMushroom good questions! Most patients will have had scans etc beforehand so the surgeon will already know where the tumour is. And if a tumour is so small the surgeon can't see it then it probably was too small to cause symptoms and may not have been picked up in the first place If they do resect normal tissue only away (never seen it happen but still could) then we'd pick that up in the lab after because we'd section and examine the tissue microscopically and see that there is no cancer there. We can also compare it to the biopsy the patient would have had to make sure it matches

unfortunately, probably not. you can ask, but they might have to dispose it. im not a medical professional by any means but i know that even some oral surgeons won't let people keep their wisdom teeth. just ask, worst they can say is no. you might be able to ask for a picture, lol

Yes. Think of it this way, If the surgeon takes what he believes to be the full tumor and closes you up - they still send the tumor to pathology to check. If it comes back that there isn’t clear margins, there will have to be ANOTHER surgery to go back in and get more tissue. If they are able to send out a bit of tissue to test during surgery to be sure, all it does is take a little more time .

Usually liquid nitrogen

Normally we fix the tissue in formalin, dehydrate it, pump it full of paraffin and slice it thin, then put it on a glass slide and stain it. Then the pathologist can look at it under a microscope. That takes about a day or so to do That's way too long if you have a patient undergoing surgery and need the result right now to decide what to do next (is there still tumour at the margin that I missed? Did I actually remove a parathyroid gland like I wanted to or is this a bit of thyroid and I need to try again?) You can freeze the tissue instead, then slice it thin and stain it and put it on a slide - it's not quite as accurate but you get the result fast enough for the surgeon to make a decision and we in pathology can check everything properly after the surgery is done and we have all the tissue and not such a hard time limit!

Normally we fix the tissue in formalin, dehydrate it, pump it full of paraffin and slice it thin, then put it on a glass slide and stain it. Then the pathologist can look at it under a microscope. That takes about a day or so to do That's way too long if you have a patient undergoing surgery and need the result right now to decide what to do next (is there still tumour at the margin that I missed? Did I actually remove a parathyroid gland like I wanted to or is this a bit of thyroid and I need to try again?) You can freeze the tissue instead, then slice it thin and stain it and put it on a slide - it's not quite as accurate but you get the result fast enough for the surgeon to make a decision and we in pathology can check everything properly after the surgery is done and we have all the tissue and not such a hard time limit!

Most of the time no! Most of the time the surgeon knows when the cancer is out - it looks very different from the surrounding healthy tissue, it feels different etc - it's easy to see so it's easy to cut out Sometimes though it's harder to tell. The cancer blends into the surrounding tissue. In those cases they might do a frozen section to check that the margin is actually clear before they stop operating and close the patient up Remember that every tumour that is removed from a patient is sent to Pathology anyway and we check the margins etc to be sure that the surgeon actually did get it all out. This process takes a few days however which is much too long when you have a patient anaesthetised in surgery and need an answer right now before you proceed with surgery - hence why we do frozens :)

@@TheKingBigfoot I see, thank you! I learned something today. ♥️

How to sterile a dog though

Yes but dogs aren’t as consistent as machinery so there’s a higher possibility of error in a situation where you do not want any error. Same reason why you still do a test swatch when a drug detection dog indicates on something, to double check and confirm. It’ll only be useful for picking out a person with cancer among a group, not to check if a tumor is completely cut out or not.

A dog won't smell the few cells that can metastasize plus if the dog smells some chemicals from the cancer then it might give a false positive as they could still be in the body while the cells are gone.

there's less dogs trained to that level and there's a larger margin for error, it wouldn't be as accessible

What we call cancer is a plethora of different pathological states. There are literally thousands. They don't have any uniform chemical characteristics. So dogs can SOMETIMES smell SOME cancer, but trust me, this is not the diagnostic tool you want.