What lies ahead
Physicians unrelated to mayor’s case explain how they examine, treat tumour
Doctors explain how they treat patients with tumours,
By now it’s firmly established and widely known that Mayor Rob Ford has a tumour in his abdomen.
Beyond that, questions abound. As doctors probe for answers in the mayor’s case — the growth is apparently in the lower-left quadrant of his abdomen — one might wonder how medical professionals turn such a discovery into a diagnosis.
Dr. Michael Bernstein, staff physician of gastroenterology at Sunnybrook Hospital, spoke to the Star about how the process typically works.
Bernstein is in no way connected to Ford’s treatment, which is being undertaken at Mount Sinai Hospital after he was transferred there Thurs- day from Humber River Regional.
“It will depend, to a degree, upon where it is: if it’s in the bowel, if it’s in the colon,” Bernstein said, explaining that doctors would use radiology imaging from X-rays and ultrasounds to find and identify a tumour. Doctors at Mount Sinai Hospital say they have not yet determined where, exactly, the mass is located.
Malcolm Moore, a medical oncologist and physician-in-chief at the Princess Margaret Cancer Centre, said it’s sometimes possible for doctors to see visually whether the tumour is malignant or benign. Even so, he said, removing a piece of the growth for microscopic examination is the only way to know for sure.
That’s why a biopsy was conducted at Mount Sinai Hospital Thursday.
“Unless the radiology is completely conclusive as to what it is, which it usually isn’t, you need to get tissue to sort out what the lesion is,” Bernstein said. The chunk of tumour removed will now be examined by pathologists, who use microscopes to determine its degree of seriousness and whether it’s cancerous. Mount Sinai’s Dr. Zane Cohen advised that it could take a week in this case. Based on what the team finds, an array of treatment possibilities opens up, ranging from chemotherapy and radiation to further surgery. “Every answer leads to its own plan of treatment, so until more information is known there’s no way to know what, if any, future steps will be taken,” Bernstein said. Yet in a case where the tumour is larger than about an inch — and Cohen told reporters that the mayor’s growth is “a fair size” — surgery to remove it is likely, regardless of whether it’s malignant or benign, said Moore. “Benign tumours can evolve into malignant tumours over time,” he said.