Clinical Report: Undiagnosed Cancer Clinic at Roswell Park

Overview

The Undiagnosed Cancer Clinic at Roswell Park Comprehensive Cancer Center provides rapid, multidisciplinary evaluation for patients with suspicious findings but no confirmed cancer diagnosis. Approximately 80-90% of referred patients are diagnosed with malignancy, while the remainder are monitored or found to have benign conditions. The clinic’s approach facilitates timely biopsies, expert pathology review, and coordinated care to optimize patient outcomes.

Background

Patients presenting with abnormal laboratory or imaging findings suggestive of cancer but without a definitive diagnosis often experience significant anxiety and uncertainty. The Undiagnosed Cancer Clinic at Roswell Park addresses this by offering expedited evaluation, including clinical assessment, imaging review, and prompt tissue biopsy. The clinic’s multidisciplinary team includes interventional radiologists and expert pathologists who collaborate to establish diagnoses efficiently. This approach enables early initiation of appropriate cancer therapies or reassurance when malignancy is excluded.

Data Highlights

In a representative case, a female patient in her late fifties presented with a palpable left inguinal mass. Biopsy revealed poorly differentiated squamous cell carcinoma with immunohistochemical staining suggesting possible urothelial, ovarian, lung, or cervical origin. Imaging and further evaluation identified a rectal mass and bilateral inguinal lymphadenopathy, leading to a diagnosis of clinical T2 N1a disease. The patient underwent concurrent chemoradiation and adjuvant therapy, with no evidence of disease on recent surveillance. Overall, 80-90% of patients referred to the clinic receive a cancer diagnosis, while 10-20% are found to have non-malignant conditions or are monitored.

Key Findings

• 80-90% of patients referred to the Undiagnosed Cancer Clinic are diagnosed with malignancy.
• The clinic offers rapid scheduling and expedited tissue biopsy, often securing diagnosis on the first attempt.
• Expert pathology review, including immunohistochemical staining, aids in identifying the cancer origin when initial biopsy is non-specific.
• Multidisciplinary collaboration facilitates comprehensive staging and tailored treatment planning.
• Patients with confirmed cancer receive timely referral to appropriate oncology specialists for therapy initiation.
• Patients without malignancy are either monitored or undergo further evaluation to exclude cancer.

Clinical Implications

Clinicians should consider referral to specialized undiagnosed cancer clinics when patients present with suspicious but unconfirmed findings to expedite diagnosis and reduce patient anxiety. Rapid access to interventional radiology for biopsy and expert pathology review can improve diagnostic yield and guide appropriate management. Multidisciplinary coordination ensures comprehensive evaluation and timely initiation of cancer-directed therapies.

Conclusion

The Undiagnosed Cancer Clinic at Roswell Park exemplifies a streamlined, multidisciplinary approach to evaluating patients with suspected but unconfirmed cancer, resulting in high diagnostic rates and optimized patient outcomes. This model supports prompt diagnosis, reduces uncertainty, and facilitates early treatment.

References

1. Mahoney M et al. Roswell Park Comprehensive Cancer Center -- Undiagnosed Cancer Clinic Case Study