Pathologist-Led Support in Palliative Cancer Care: A Consultative Approach to Enhancing Patient Understanding,Concerns,and Autonomy

Abstract

Introduction

This report introduces a unique outpatient service led by a pathologist at a cancer palliative care–specialized hospital in Japan. Since 2015, the “Knowing the Disease Well” clinic has aimed to enhance patients’ understanding of their disease—an essential foundation for envisioning their future—and to support the cultivation of autonomy in decision-making.

Methods

The clinic offers weekly one-hour sessions, free of charge, for cancer patients and their families. Consultations cover medical explanations (diagnosis, pathological findings, test interpretation, treatment plans, disease trajectory) as well as emotional and existential concerns such as anxiety, prognosis, and family relationships.

Results

Between May 2015 and March 2025, 37 cancer patients aged 30-80 years attended the clinic (Table 1). Over the past decade, 452 consultations were conducted, with family members present in some cases. Patients often reported relief, clarity, and strengthened autonomy. A representative case of a breast cancer survivor illustrates how tailored communication helped restore emotional balance and confidence in her future.

Conclusions

These findings suggest that counseling by pathologists can serve as a meaningful and underutilized component of comprehensive palliative care. Further study is needed to evaluate its broader impact and to explore its potential in other clinical settings.