Shining a spotlight on chemical pathology

Consultant Chemical Pathologist, Dr Ruth Ayling, tells us about her role and how her work helps inform key decisions about diagnosing, treating and caring for people with bowel cancer.

What is your role and why did you decide to become a Chemical Pathologist?

I am a Consultant Chemical Pathologist at Barts Health NHS Trust. Pathology is the study of disease and Chemical Pathology (sometimes called Clinical Biochemistry) involves the study of body fluids and diagnosis of disease from abnormalities of biochemistry in these fluids.

I provide the medical input in a large multi-professional team which processes body fluids, mainly blood, urine and poo, in our four hospital laboratories.

At medical school I was lucky enough to have the opportunity to spend an extra year studying biochemistry and that was where my interest began. Pathology is the science behind the disease and I wanted a career where I could practice both science and medicine.

What does your typical day at work look like?

One of the reasons I like being a Chemical Pathologist is because there is no such thing as a typical day - my days are extremely varied. My clinical duties include seeing and treating patients with biochemical disorders and attending meetings with clinicians in other specialties to provide clinical biochemistry input.

I also work in the laboratory interpreting the results of the tests we have performed. This can sometimes be like scientific detective work. I also liaise with the doctors caring directly for the patients concerned to discuss the results.

What is the best part about your job?

Many patients have probably never heard of a Chemical Pathologist and may have little idea what one does. The best part of the job is knowing that my work is an essential part of patient care.  It is integral to many clinical decisions and provides essential information for the prevention, diagnosis, treatment and management of disease.

Why is Chemical Pathology so important for bowel cancer patients?

The work that we do in the laboratory is important for patients with bowel cancer for a number of reasons. We process samples from outpatients attending clinics or for pre-assessment, from patients on our hospital wards after surgery and from General Practice.

The blood tests we perform include those that check out how well the kidneys and the liver are working and tumour markers (called CEA and Ca19-9) which may be measured to check how cancer treatment is working.
We also carry out faecal immunochemical testing (FIT), checking for blood in poo. This service is separate from, and in addition to, the Bowel Cancer Screening test (which is offered to all healthy older people) – and something Bowel Cancer UK have blogged about before.

We test patients who have symptoms but are thought to be at low risk of bowel cancer and don’t fulfil criteria for an urgent referral to hospital. An abnormal test result flags to the GP that the patient requires immediate investigation which could help detect bowel cancer at an earlier stage.

• Find out more about the other healthcare professionals who may be involved in bowel cancer diagnosis, treatment and care

• Read how bowel cancer is diagnosed

• Find out about pathology