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Improving Biopsy Protocol Article

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Posted 10/24/2009 5:26 AM (GMT 0)

Here is a link to a  MedWire piece about an article in the Journal of Urology.  It deals with improved biopsy protocols that help in the prostate cancer treatment decision-making process.

This article caught my eye because it quoted Jonathon Epstein from Johns Hopkins, a world-class expert on prostate biopsy interpretation.  He did a second opinion interpretaion of my own biopsy slides.

This may be of interest to some of you as it was to me.  

http://www.medwire-news.md/46/84919/Oncology/Improved_biopsy_protocol_recommended_in_active_surveillance.html

Posted 10/24/2009 5:19 PM (GMT 0)
These guys are still missing it. This article is more detail on the Hopkins study of AS which concluded that low grade tumors rarely progress and progression in AS patients is due to mis sampling of high grade tumors in the initial biopsy. They recommend that 2nd biopsies sample the anterior as this is where most of the undetected tumors were located.
If all AS patients were given a color doppler ultrasound this would eliminate practically all of the transition zone tumors that were not found on the initial biopsy.
Initial biopsies rarely sample the transition zone and 20-25% of all tumors are found there.
Color Doppler Ultrasound biopsies are given by interventional radologists and urologists consider biopsies their territory and are very relunctant to refer patients outside the urological community for biopsies.
This is an example of where we have an excellent tool for PC detection that is not being used because of inter disiplainary rivilry, and it is hurting us patients.
JohnT
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