Intra-operative Diagnostic Techniques Used to Improve Cancer Cure

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I attempt to maximise cancer cure in a number of ways. 

I do a very systematic biopsy before the operation. 

I know exactly where the cancer is or get a good idea where the cancer is and we will design the operation for that particular cancer in that particular patient. 

Now during the operation if the tissue separates very easily we’re confident we’re in the right plain, there’s no cancer there but if it doesn’t and it’s hard to dissect free I will do a frozen section where I will send some tissue off during the operation to check that there’s no cancer outside the prostate. 
I also do that routinely where we dissect the prostate from the neck of the bladder and from the urethra, the front of the prostate and the apex, the very front where often cancer can extend to. 

This gets sent off and I really believe it’s important and it helps patients because you will find that there may be unexpected cancer there during the operation and we will have that result back in 15 minutes so we can modify the operation, rather than waiting two or three days after the operation and finding out the cancer is unexpectedly beyond the confines of the prostate and at that stage it’s too late to remove further tissue. 

So this data is getting analysed at the moment, I’m very pleased to note that last year at the American Neurological Society meeting, the group from the Memorial (1.30) presented their data on frozen sections, taking extra tissues and they found and they found unexpected cancer and they went further and cleared it but these patients behaved like their cancer had been removed completely. 

So this confirms the validity of this. 

Some centres don’t do this because it’s a lot of trouble to go through but I’ve done this with my pathologist from day one with all 350 cases, they’re very, very good at now, they do it in 15 minutes, it doesn’t slow our operation up at all and patients when they have this, when they have this explained to them they understand that it’s important and they all you know they all feel very confident that we’re doing that additional work in theatre.