From Visible to Invisible: Molecularization of Practice in Histopathological Diagnosis of Lung Cancer

• In Event: Producing Transformations: Drugs, Bodies, and Experimentation 3

Abstract

Many targeted drugs treating lung cancer are available on the market in the recent decade, and their effectiveness for selected patients has been well-established in clinical trials and current treatment guidelines. Whether or which gene mutated plays a critical role in the management of certain patient groups. Therefore, the guidelines have recommended more different genetic tests during the process of diagnosing lung cancers, which in the meanwhile transformed pathologist’s practice on tissue diagnosis from their traditional gold standards of morphology to the invisible genetic molecules.
According to document analysis and participant observation, I noticed a process of molecularization on thinking and practical process during the diagnosis work. Compared with the distinction between small cell and non-small cell lung cancer in the past, pathologists now make more efforts to diagnose adenocarcinoma from other subtypes in the first small biopsy with the aid of immunohistochemical stains. At the same time, owing to limited tissue amounts from the single biopsy and more and more recommended genetic tests, pathologists also cut the numbers of the stains they use, saving more cancer cells for further molecular testing.
The molecularization of diagnosing practices doesn’t only demonstrate changes in classification work by pathologists in the era of precision medication but also inevitably reforms the biomedical platform of diagnosis and treatment under the politicoeconomic framework of the current health system.

Author

• Yeh-Han Wang, Institute of Science, Technology, and Society, National Yang-Ming University