We are top experts in cancer diagnosis and molecular testing and believe you don't have to live within driving distance of top academic medical centers to get such expertise for your care.
We offer second opinions and expert interpretation of both Molecular testing reports and treatment decisions.
For secondary review of your molecular test findings, please obtain a copy of your molecular report, the corresponding surgical pathology report, as well as a recent oncology progress note for our review
Our pathology, genomics, and oncology experts will do an in-depth analysis of your clinical situation and the results of existing molecular testing, rendering a medical report consultation.
For our genomic sequencing services, please refer us to your physician for registration and access to our requisition forms.
Why experts matter
Molecular tests assays, especially Next-Generation Sequencing (NGS), are extremely complicated and difficult to interpret, requiring expertise in genetics and genomics.
Oncologists, particularly those in the community setting, generally do not have the tools and experience in this field and thus do not sufficiently understand these test results to make full use of them.
Medical mistakes can happen when these tests are interpreted by those without sufficient understanding in the molecular diagnostic space. Additionally, many laboratories do not interpret the case in the context of the patient, but instead utilize automated processes to identify possible significance to any detected mutations. Many of these interpretations are not medically sound or written by physicians.
On the dangers of misinterpretation, from the Washington Post (link):
When such complicated genetic tests are left to the interpretation of novices in the field, mistakes can happen. See below for a recent example from The Washington Post about a woman who had her breasts and ovaries removed because her physicians did not understand the findings of the genetic tests, that actually conveyed a negative test.
What is unique about precision Medicine?
Cancer is generally considered a GENETIC disease. This does not imply heredity in most cases, but that genetically and tightly-controlled cellular processes are altered, leading to uncontrolled cell growth (i.e., cancer).
Next-Generation Sequencing (NGS) allows us, for the first time, to see the genetic make-up of the tumor. This allows us to see “under the hood”, and identify what cellular processes have gone awry and to assess their impact on the patient. Knowing these processes is beneficial, because targeting these altered processes gives us the best opportunity to stop the mechanisms that are driving the tumor.
This is the principle of Precision Medicine
A note on the current state of precision medicine in cancer
Broad-based sequencing of cancer-associated genes is an exciting and still very new field.
A key differential from traditional cancer care is that we take a mechanistic approach to the patient- namely, find out what is causing the cancer, and address it. This is a radically different perspective than the previous methodologies.
Because treating patients based on molecular knowledge gathered from individual patient genomic information is still very new, insurance companies and Medicare at this time are still not certain how to cover these kinds of services. Every day, more and more clinical trials (typically in the form of "umbrella" and "basket" clinical trials, that focus on targeted therapies and pathways of disease rather than testing one established drug tested in a very specific cancer type versus another) are validating this approach. Additionally, precision medicine is rapidly becoming the consensus approach to best treat some patients in academic centers.
However, due to this novelty, some insurance companies and some Medicare Administrative Contractors (MACs) are not paying for these services. This has made it very difficult to move this field forward and get people the testing they need. Because of this, we may balance bill you for the services rendered through our physician services.