PROFESSOR OF SURGERY, UROLOGY AND RADIATION ONCOLOGY
HEAD, UROLOGIC ONCOLOGY
UNIVERSITY OF COLORADO
ANSCHUTZ MEDICAL CAMPUS
E. David Crawford, MD
Frequently Asked Questions:
FAQ: 3D Staging Biopsy
What is 3D Staging Biopsy?
3D Staging Biopsy is a specialized biopsy technique where Dr. Crawford, with the aid of ultrasound guidance and revolutionary new software, systematically removes biopsy samples of prostate tissue and records their specific location. Once completed, a pathologist (doctor that analyzes tissue for abnormalities) thoroughly inspects each sample and creates a detailed report of their findings on each individual specimen. Unlike transrectal biopsies, which are performed through the rectum, 3D Staging Biopsies are sampled from the perineum (area of skin between the scrotum and anus). This allows Dr. Crawford to take a greater number of samples as well as establish a proper “vantage point” for them to access your prostate again if you decide to undergo targeted treatment.
How Long Does the Procedure Take?
Typically, the procedure itself takes about one hour to complete. You will be asked to report to the hospital about 2 hours before your procedure so that the hospital staff can get you prepared. After the procedure, the hospital will release you once they feel that the anesthetic has adequately worn off.
Will I be able to feel anything during the procedure?
No. In order to perform 3D Staging Biopsy, the patient will be placed under general anesthesia by an anesthesiologist to ensure they are in an optimal state of comfort. Similarly, general anesthesia is extremely important since the precision of 3D Staging Biopsy relies on ensuring the patient remains extremely still. Even the slightest movement by the patient can create errors in the results.
Will I have to Stay Overnight at the Hospital after my Procedure?
No. A 3D Staging Biopsy is an outpatient procedure, which means that the patient returns home the same day of surgery. Only in very rare instances will a patient be required to stay overnight.
Why is it called “3D” Staging Biopsy?
We use the term “3D” to refer to the 3-Dimensional, real time image the surgeon and researchers create during the procedure. The specalized software (only available to us at the University of Colorado) allows us to literally map the exact location of each and every single biopsy taken within 1 or 2 milimeters. Once the procedure is complete, the software allows us to input and literally “map” the location of each positive cancer specimen onto the 3D image. This creates not only an indispensible visual aid for the patient but also a valuable tool for our team to assess the best course of treatment to take.
Can I get a 3D Staging Biopsy from my local urologist?
No. We are the only site in the country that can conduct this procedure since we designed and developed the software in house.
How do I know if I'm a candidate for 3D Staging Biopsy?
The best way to determine if 3D Staging Biopsy is right for you is to contact us via email or telephone. There are many factors that go into making an "ideal candidate" and talking to one of our expert researchers is a good place to start.
What is the difference between MRI Guided Biopsy and 3D Staging Biopsy?
The problem with MRI guided biopsies is that they don't always differentiate between normal and cancerous tissue. In fact, they often miss about 20-30% of high grade cancers. Since there is no imaging that can accurately identify cancer in the prostate, we sample the ENTIRE gland, ensuring the patient is accurately diagnosed.
FAQ: Targeted Focal Therapy
What is Targeted Focal Therapy?
Targeted Focal Therapy is a revolutionary treatment option for organ confined prostate cancer that treats only the area of cancer. This technique utilizes the specific cancer location results from a 3D Staging biopsy procedure and freezes the area of cancer with specially designed probes (see right). A series of freezing/thawing steps literally ruptures the membrane surrounding the cancer cells, effectively killing them.
How do I know if I’m a good Candidate for Targeted Focal Therapy?
This is completely up to the discretion of Dr. Crawford. Generally, individuals with less than 5 positive cores on 3D Staging Biopsy and Gleason 7 or less are candidates for Targeted Focal Therapy. There are some instances, such as close proximity to the urethra or prostatic capsule (near the edge of the prostate) where Dr. Crawford may not recommend Targeted Focal Therapy, but each case varies.
How long does the procedure last? Do I have to spend the night at the hospital?
Once you are brought into the operating room, the procedure lasts approximately 1.5 hours. Because of the precision of Targeted Focal Therapy, you will be placed under general anesthesia to prevent any movement during the procedure as well as maintain maximum patient comfort. Much like 3D Staging Biopsy, Targeted Focal Therapy is an outpatient procedure, meaning the patient leaves the very same day of the procedure. Typically, the patient is sent home with a catheter for 3-5 days.
If I’m a candidate for Targeted Focal Therapy, how does the surgeon know exactly where my cancer is located?
During 3D Staging Biopsy, our real time software outlines the exact contour of your prostate. In patients eligible for targeted focal therapy, Dr. Crawford and his team use the 3d model from your 3D staging biopsy to line up your prostate to within a few milimeters of its position during the staging biopsy. Freezing probes are then placed into the areas of cancer that are visible on the real time, 3d model. We are the only institution in the country that can confidently and accurately treat ONLY the area or areas of cancer in the prostate.
Does Dr. Crawford Treat other Cancers besides Prosate?
Yes! Not only does Dr. Crawford treat all types of prostate cancer (early, late stage, metestatic) he also is an expert in treating kidney, testis, and bladder cancers in all stages. He's also an expert in treating benign conditions throughout the urinary system.