The availability of an effective treatment improves the diagnostic process


The diagnostic pathway is a complex process of hypothesis generation, contrasting information and pattern recognition, under the influence of the environment and the cognitive and emotional aspects. The availability of an effective treatment for a particular problem  has a positive impact on the whole process…

One example to explain this is testicular cancer, an aggressive tumor now considered a curable disease in more than 95% of patients after the introduction in the eighties of chemotherapy based on Cisplatin (1).  I have seen in the last years  a better clinical performance in the urologist and medical oncologist and, what is even more important, the spreading of the knowledge about the existence of this tumor in the group of people between the age of 25 and 35 where this tumor has the highest incidence. Patients now are aware of the problem and they go to the doctor,  the urologists know that time is crucial to start a treatment and there is usually no delay in diagnosis.  A testicular lump is the most common symptom of alarm and due to the fact that  every player knows the importance of the problem and the high level of cure  this tumor is one example of a change in the clinical practice based on the availability of a very effective treatment.

(1) Moul JW, Paulson DF, Dodge RK, Walther PJ. Delay in diagnosis and survival in testicular cancer: impact of effective therapy and changes during 18 years. J Urol. 1990 143:520-523