Biopsy

BOSTON -- Ira Wilson prefers to think of it as a biopsy rather than a study. In a biopsy, after all, a small sample of tissue says a great deal about the patient. In this case, the patient is the health care system itself and the biopsy that Dr. Wilson performed with Matthew Wynia and others was on 720 doctors. They collected and dissected information about how doctors deal with insurance companies. Their "biopsy report" in the Journal of the American Medical Association diagnosed a runaway case of deception.

Dr. Gary S. Hill, an internationally renowned renal pathologist and the former chief of pathology at Johns Hopkins Bayview Medical Center, died Tuesday from lung cancer. He was 74. Dr. Hill pioneered a new technique for biopsies of tissue, in addition to developing a system for identifying lupus and how far the disease had progressed in a patient. Colleagues and family described him as a man greatly interested in conversation and friends, traits that translated into the way he moved forward in his career.

Prostate cancer by the numbers Each year: It kills about 30,000 1.3 million men undergo prostate cancer biopsy 230,000 found to have prostate cancer

Prostate cancer by the numbers Each year: It kills about 30,000 1.3 million men undergo prostate cancer biopsy 230,000 found to have prostate cancer

A state health claims arbitrations panel has assessed $408,000 in damages against a Westminster urologist for failing to detect prostate cancer in a patient while the disease was at a curable stage.In a decision issued Nov. 30, the panel found that Dr. Reynaldo Madrinan was negligent in the treatment of a former patient, Charles Fitzgerald of Westminster.Mr. Fitzgerald, 52, was diagnosed with prostate cancer in June 1994.If he had been diagnosed earlier, while under the care of Dr. Madrinan, his cancer could have been treated, said Phillips P. O'Shaughnessy, Mr. Fitzgerald's lawyer.

Loyola women's lacrosse coach Diane Aikens moved out of intensive care yesterday, one day after surgery to remove a brain tumor. The results of a biopsy are expected this weekend.A fund has been started for Aikens that will pay medical expenses not covered by insurance. Contributions can be mailed to Loyola College Athletic Department/Diane Aikens Fund, 4501 N. Charles St., Baltimore, Md., 21210.For questions relating to the fund, contact Dave Gerrity at (410) 617-2547.

A new study has raised serious questions about radiologists' reliability in reading mammograms and making recommendations about what to do when a suspicious lesion is found in the breast.The study, by researchers at the Yale University School of Medicine and published yesterday in the New England Journal of Medicine, found that radiologists who read mammograms can vary considerably in their interpretations of the X-ray films and in the advice they would give to women.Where one radiologist might recommend an immediate biopsy, another looking at the same mammogram might suggest a repeat X-ray in three months, and still another might suggest waiting a year to do another mammogram.

The Rev. Bert Benz's condition continues to improve and has been upgraded from critical to serious.Doctors are pleased with his progress, said Kay Yeltin, spokeswoman for the Markey Cancer Center, University of Kentucky, in Lexington, where the Hampstead minister has been a patient for nearly a month.Benz, pastor of Faith Baptist Church, has chronic myelogenic leukemia. The 47-year-old received a bone marrow transplant from his daughter, Lauren, 12."The reverend has been moved from the intensive care unit," Yeltin said Friday.

Q: During a check-up last week, my doctor discovered a small lump in my thyroid gland. The possibility of thyroid cancer was suggested, and I made an appointment to see a specialist. What is the chance that a thyroid lump is cancerous and how is the diagnosis made?A: Thyroid lumps (nodules) are quite common. In adults they are present in about 6 percent of women and 2 percent of men; they are more frequent in elderly individuals. Approximately one thyroid nodule in 20 is malignant.A thyroid nodule is more likely to be malignant in men, in younger people, in those with a family history of thyroid cancer, and especially in people who had irradiation treatment to the head and neck during childhood or adolescence.

She is 54, not young, not old. Her yearly mammogram showed a small lump. "Highly suspicious," said the radiologist. The doctor recommended a biopsy. She knew then her life could change forever.I'll call her Ella. She is one of my closest and dearest friends. She lives in the nation's capital.The part of her tedious journey from breast cancer discovery to recovery over a three-year period that most frightened me and frustrated her were the terrible decisions she had to make on her own and the controversy surrounding various procedures.

Johns Hopkins researchers say they have devised a more accurate blood test for prostate cancer that could eventually replace PSA screening, flagging more malignancies while reducing the number of false alarms. The scientists, who reported their findings today in the journal Urology, say the test could spare thousands of men painful biopsies that turn out negative every year. "We're biopsying a lot of men who don't have prostate cancer," said Dr. Robert H. Getzenberg, director of urological research at the Johns Hopkins Brady Urological Institute.

PHILADELPHIA - A breast biopsy that comes back benign is reassuring to most women, but about a third are at significantly higher risk of breast cancer and need to discuss their options, a new study concludes. Those options include taking tamoxifen, undergoing genetic testing and supplementing regular mammography with breast MRIs. "There are different categories of benign biopsies, and they convey different risks," said Mayo Clinic oncologist Lynn Hartmann, who led the study published in today's New England Journal of Medicine.

Five years ago, Tony Caputi had a common blood test for prostate cancer known as a PSA. Afterward, he felt relieved: His reading was 1.1, and most doctors believed that anything under 4 was normal. But during a subsequent internal exam, a physician noticed something suspicious and recommended a biopsy. It turned out that Caputi, then 43, had prostate cancer after all. "Just based on the PSA alone, I was below the threshold," said Caputi, who works for the American Foundation for Urologic Disease in Linthicum and whose cancer is now in remission.

FORT LAUDERDALE, Fla. -- Orioles catcher Brook Fordyce, who lost five pints of blood when an artery burst between his stomach and esophagus in January, got some long-awaited good news yesterday. The biopsy that was performed to determine the cause of the incident showed nothing to indicate it was the result of a serious disease. Fordyce, understandably relieved, said he has been assured that a recurrence is unlikely if he avoids aspirin products and anti-inflammatory medication and takes an acid-neutralizing medication regularly.

BOSTON -- Ira Wilson prefers to think of it as a biopsy rather than a study. In a biopsy, after all, a small sample of tissue says a great deal about the patient. In this case, the patient is the health care system itself and the biopsy that Dr. Wilson performed with Matthew Wynia and others was on 720 doctors. They collected and dissected information about how doctors deal with insurance companies. Their "biopsy report" in the Journal of the American Medical Association diagnosed a runaway case of deception.

A new type of PSA blood test could spare up to 200,000 men a year the need for painful biopsies to determine if they have prostate cancer, doctors in a large national trial said yesterday.The test, which received government approval in February, helps to distinguish between early-stage prostate cancers and benign conditions that should merely be watched."Medical science has come up with a more rational approach to screening for prostate cancer," said Dr. Alan Partin, a urologist at Johns Hopkins School of Medicine, one of seven medical centers involved in the study.

Five years ago, Tony Caputi had a common blood test for prostate cancer known as a PSA. Afterward, he felt relieved: His reading was 1.1, and most doctors believed that anything under 4 was normal. But during a subsequent internal exam, a physician noticed something suspicious and recommended a biopsy. It turned out that Caputi, then 43, had prostate cancer after all. "Just based on the PSA alone, I was below the threshold," said Caputi, who works for the American Foundation for Urologic Disease in Linthicum and whose cancer is now in remission.

Many women are expected to use the National Cancer Institute's change of heart as an excuse to avoid an examination they were never really comfortable with in the first place.Having a mammogram is inconvenient, possibly expensive (even with mandated insurance coverage, there is usually a co-payment), uncomfortable and frightening."They might find something" is probably the leading reason why two-thirds of women have so far avoided this examination. Another common excuse is a fear that the X-ray examination itself might be harmful.

After a recent chest X-ray, my doctor told me I might have sarcoidosis. What causes it, how can I be sure I have it, and how is it likely to affect me?The dictionary defines sarcoidosis as a chronic disease characterized by the development of lesions similar to tubercles in the lungs, bones and skin. Sarcoidosis occurs throughout the world. An estimated 2.4 percent of blacks and 0.85 percent of whites are at risk to develop sarcoidosis during their lifetimes.What causes sarcoidosis is unknown.

A state health claims arbitrations panel has assessed $408,000 in damages against a Westminster urologist for failing to detect prostate cancer in a patient while the disease was at a curable stage.In a decision issued Nov. 30, the panel found that Dr. Reynaldo Madrinan was negligent in the treatment of a former patient, Charles Fitzgerald of Westminster.Mr. Fitzgerald, 52, was diagnosed with prostate cancer in June 1994.If he had been diagnosed earlier, while under the care of Dr. Madrinan, his cancer could have been treated, said Phillips P. O'Shaughnessy, Mr. Fitzgerald's lawyer.