Dr. Myers then presented an overview of prostate cancer knowledge ranging from the most basic concepts to some of the newer ideas. He discussed the pathways that PC may follow as it metastasizes in the body.
While talking about these issues he pointed out the difficulty in being certain about the nature of the original tumor. Gleason Score is still a pillar of PC analysis and a key component in building predictions about future behavior. And Gleason Score is STILL being determined by eyeball subjectivity.
A pathologist looks at a slide under a microscope and matches the qualitative characteristics of the tumor cells he has identified with a “standard scale” developed by Dr. Donald Gleason many years ago. Any patient receiving the pathologist’s initial analysis should be certain to obtain a second opinion by an expert prostate pathologist.
Gleason grade and score are key predictors of future behavior of a PC tumor and should have confirmatory analysis.
He addressed the issue of why cure is so difficult. We’ll go into more detail about this part of his talk in the follow-ups to this Overview.
COLOR DOPPLER AND SATURATION BIOPSY
Dr. Gary Onik, of Celebration, FL, is a Cryosurgeon of wide experience in this rapidly emerging non-surgical, tissue ablation therapy. He practices at Celebration Health Hospital outside of Orlando.
In his talk Dr. Onik discussed the difficulty of finding a small tumor inside a typical plum sized prostate using conventional needle biopsy techniques. He also talked about the advantages of locating tumor in the gland by means of Color Doppler Ultra Sound (CDUS) technology. He set the groundwork for the saturation biopsy technique he now uses.
Dr. Onik went through the advantages of CDUS in prostate diagnosis. But he also pointed out some of its limitations. Although it is better than standard US, he believes better techniques are needed. Since he was discussing the “male lumpectomy” wherein only that part of the gland containing confirmed tumor is removed, he was building his case for what he calls “3D Global Mapping Biopsies”.
If a saturation biopsy technique like this can establish that significant tumor only exists in one accessible region of the gland, then the “Male Lumpectomy” procedure with cryosurgery should be useful.
This presentation was one of the best at the Conference.
Onik’s prostate lumpectomy approach can spare many men from the always attendant morbidity and side effects of the more established other tissue ablation methods, including surgery (open, laparascopic, or robotic) and radiation (brachytherapy, external beam with its modern variants).
The obvious risk in this approach is that because PC is focal, some foci of tumor will be left in the gland after the lumpectormy is completed, and there will be subsequent recurrence. We will discuss this in more detail in our later writeup of the event.
Reported by David S. Most, Ph.D.
Int'l Conference on Prostate Cancer, 2006
|Screening for Pca - Pros/ConsDr. David Crawford
Intl Conf on Prostate Cancer, 2006|
|PROSTASCINT w/CT Fsionu in DiagnosisDr. Bruce Sodee|
International Conference on Prostate Ca, 2006
|Remember we are NOT Doctors and have NO medical training.|
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