EXPANDING ROLE: Cytotechnologists arebeing called on to provide their expertisefor collecting and interpreting samples andresults outside their normal scope.

hrlystery DiagnosisPuzzling through interpretations, servingpatients and tackling new technologies keepcytotechnologists engaged. u, Kerri Hatt

ytology is truly a field where youcan faithfully use the phrase,"you learn something new every

Yday," according to Nick Hoover,CT(ASCP), senior cvtotechnolooisrL I (ASLI'), senior cytotechnologist,Brigham and Women's Hospital Depart-ment of Cytopathology, Boston. ,,I neverfeel there is a repetitious or dull day inthis field," he totd ADVANCE. Cytologistsspend their time looking at such a varietyof specimens that each case can be a chal_lenging puzzle. Vivian pijuan:IhompsorL

PhD CT(ASCP), assistant professoi andCytotechnology Program director, TheUniversity of ,.A.labama at Birmingham;and ASCT Region Four regional director,

said each case is a mystery that needs tobe soived. "I love the fact that cytology hasbecome very dynamic and enjoy learn_ing about the new technologies and theirapplications," she noted.

For Susan Warren" SCT(ASCp) CT(ASCP)(IAC) charge cytotechnologisf FletcherAllen Heaith Care, Buriington, V! the bestpart of working in cytology is the indepen_dence, the focus and concentration needed,as well as the application of well_definedcriteria to come up with a diagnosis.

A Final ProductCytologists have tremendous input into afinai product: a cliagnosis, Warien noted.

"Cytology is different from other labora-tory positions in this sense: you take ininformatiory the puzzle pieces if you will,and come up with solutions (i.e., diagnoses)from incorporating the entire picture ofthese pieces (i.e., clinical information andmorphologic interpretation),, she added."You create your own interpretation andinteract and assist the pathologists withthe final diagnosis."

Timahnie Ames, CT(ASCp), senior staffcytotechnologis! Incyte pathology, Spo_kane W4 and ASCT Region One regionaldirector, pointed.out how cytotechnolo-gists work closely with pathologists pro_viding ehrly detection of life-threateningconditions, helping patients get treatmen-tin a timely and life-saving manner.

DiversificationIn addition to shaping the prevention andtreatment of disease for many patients,cytology professionals earn comfortablesaiaries and benefits. Working with thepathology team affords a certain amountof independence to cytologists, whichopens up multipie avenues for growth,depending on one's strengths and inter-ests, Warren expressed.

Cytotechs can move into management(e.g., cytology superviso4. anatomic"pathol-ogy manager), academia (e.g" educationcoordinator, professor) research, quaiityassurance or private industry (e.g., equip_ment sales, applications). The technicaladvances have allowed the fietd to evolvetremendously, opening up many facetsto the profession, allowing cytoiogiststo diversify more than ever, Dr. piiuan-Thompson added.

Indeed, Hoover focuses on cytoprepara_tion management and has recently startedcross training as a cytogenetics techni_cian; while Dr. Pijuan-Thompson usesher training to research disease processescausing brain tumors and cervical cancer.

16 ADVANCE for lVledical Laboratory Professionals I November ,l,2010 | www.advanceweb.com/MLp

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SPREADING KNOWT_EDGE: Susan Warren,SCT(ASCP), CT(AScp), (tAC), educates localcytotechnologists about staining pap smearsin Matagalpa, Nicaragua.

Additionally, cyto professionals can workin a host of different settings, from privatelabs, to academic medical centers, commu-nity hospitals or research {acilities.

Cytology will always be important tohealthcare, Ames stressed, so profession-als in the field enjoy the iob security of alasting industry. Additionally, cytollgistshave a strong support system, Ames noted,through groups like the American Soci-ety for Cytotechnoiogy and the AmericanSociety of Cytopathology. ,,The nationalorganizations for cytology do wonderfulthings to heip the cytology communitythrough work with continuing education,current events in our field, informationabout meeting, schooling and what ishappening with legislative issues.,,

Taking an Active RoleKeepingup is important in such a dynamicfield which is undergoing man1, changesas the result of new technologies, fromautomated screening devices, to florescenthybridization testing; and breakthroughEincluding the HPV vaccination.

Predicting where the field will go inthe future can be difficult, a, mu.ry Jf thetechnologies in place today didn;t seempossible 10 years ago, Ames said. How_ever, the core focus remains diagnosis,and cytotechs are flexible enough to inte_grate new developments to improve andcomplement patjent care.

While new technologies are movingthe field toward a broader base involvingmolecular diagnostics, genetics, persbnaimedicine and automated assisted diag_

nosing, Hoover believes the glass slide,accompanied by human knowledge andinterpretatiory will remain the moJt inte-gral part of cytology.

"In my opinion, it is an exciting time tobe involved in cytology as a cytotechnolo_gist " he said. "We have the opportunityto become even more exact in our diag_nosis with the assistance of molecula'rtechniques and genetics. We also havethe opportunity to use new engineeringadvances to become more efficient andcost effective.'. However, he cautionedcytotechnologists must take an active roleto embrace new technology and developtheir careers to prevent being left behind.

Using molecular diagnostics to hone,specify and complement the morpho_logic features of cytopathology will leadto new and improved treatments, Warrenpredicted, and focusing on areas such ascirculating tumor tell analysis will helopl-rysicians target.therapies not only to spe-cific types of canceq, but also to specific cel_lular and molecular sites for these targetedtherapies. These developments couljleadto treatments which are more effective, yetIess toxic than traditional methods, likechemotherapy, Warren noted.

Warren expects cytotechsl roles will'expand to incorporate. some patholbgyassistant tasks and skills into their reper_toires, which could include anything fromspecimen collection in the non_gynecologicrealm (e.g., fine needle aspirations) to the,triage of these specimens for initial patho_Iogic workup. "Our role may expand frombeing able to only render statements of ade-quacy on these specimeng,, she said.

- Dr. Pijuan{hompson agreed, noting

she sees increased roles for cytotechs inperforming and interpreting moleculartests such as fluorescence in situ hybrid_ization that utilize cytomorphologic skills."I look forrvard to the opportunities wenow have to redefine the profession andwhat we do," she related. E

Kerri Hatt (khatt@adztanceweb.com) is manag_ing editor o/ADVANCE.

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