Uncommon Expertise: Pathology at GBMC

There are many reasons GBMC is home to Maryland’s largest community cancer program. Not all of them are found in the Sandra and Malcolm Berman Cancer Institute.

"One of the things that sets our cancer program apart is our patients have the services of a first-rate pathology group," Paul Celano, MD, FACP, FASCO, Herman and Walter Samuelson Medical Director of GBMC's Sandra and Malcolm Berman Cancer Institute, said.

Robert A. Palermo, MD, and the pathologists in the Department of Pathology and Laboratory Medicine at GBMC are unseen heroes in the diagnosis and treatment of cancer patients. Dr. Palermo leads a team of six pathologists who consult with oncologists, as well as clinicians from all services, in the pathologic evaluation of specimens collected from their patients and provide diagnoses to guide the patient’s clinical care.

Pathologists at GBMC have the opportunity to practice general surgical pathology and cytology to evaluate specimens from virtually all organ systems. Dr. Palermo and his team of anatomical and clinical pathologists bring a variety of professional perspectives and training experiences to their work.

“Often in academic and large multi-institutional settings, there are pathologists who specialize in a specific area/organ system such as breast or hematologic diseases," Dr. Palermo said. “Because we’re seeing all types of conditions, benign and malignant, of every organ type, meeting as a team gives us the opportunity to collaborate to achieve diagnostic consensus, particularly regarding challenging cases.”

The team consults with each other each morning in an intradepartmental case conference. They also work to ensure their findings are clearly and consistently communicated. With the arrival of MyChart, they are reporting not only to the oncologists, but also to their patients.

“We’re always mindful of that,” Dr. Palermo said. “Oftentimes, we’ll discuss how pathologic findings are worded in consideration that the patient may see the diagnosis before the clinician does.”

Lindsay B. Goicochea, MD, an associate pathologist and medical director of the Cytopathology section of the department added, “Most of our communication with clinicians occurs through the pathology report, where pathologic tumor staging and other pathologic findings are fundamental elements utilized by oncologists in the formulation of a patient’s treatment plan, including patient eligibility for additional treatment such as chemo/immunotherapy and/or radiation therapy.”

Head and neck surgeon Farzad Masroor, MD, of GBMC’s Milton J. Dance Jr., Head and Neck Center, said his patients benefit from the pathologists’ expertise.

“At GBMC, there is a long history of expecting the same level of care as in an academic hospital,” he said. “Pathology has greater demands placed on it. They are asked to function at the level of an academic institution and GBMC does that.”

Dr. Celano added, “When we talk about patient-centered, multidisciplinary care, we say there is a full medical team, beyond oncology, that is directly involved in each patient's care. Dr. Palermo and the team of pathologists participate in our tumor boards; they consult with our oncologists in determining the best course of treatment for each patient."

GBMC oncologists and their patients rely on the precision of these pathologists. The focus on quality is something that attracted Dr. Palermo to the practice more than 40 years ago. Now, as he makes plans to retire, he takes pride in the standards and practices the laboratory has innovated.

Dr. Goicochea sees the results. “When our laboratory has the opportunity to perform a College of American Pathologists (CAP) accreditation inspection of other hospital laboratories, we are able to appreciate the quality of service we provide and how well-developed our quality program is at GBMC, and much of that is a reflection of Dr. Palermo’s leadership over the years and his dedication to a quality pathology program.”

Given GBMC’s commitment to excellence, cancer patients will continue to have top-notch pathologists in their corners for years to come.