EH 3_2015

DO YOU WISH TO RECEIVE EUROPEAN HOSPITAL Yes No AND THE EH ONLINE NEWSLETTER? Reader Number Name Job title Hospital/Clinic Address Town/City Country Phone number Fax E-mail address For new EH registrations, tell us more about your work, so that we can plan future publications with your needs in mind. Please put a cross in the relevant boxes. 1. SPECIFY THE TYPE OF INSTITUTION IN WHICH YOU WORK General hospital Outpatient clinic University hospital Specialised hospital/type Other institution (e.g. medical school) 2.YOUR JOB Director of administration Chief medical director Technical director Chief of medical department/type Medical practitioner/type Other/department 3. HOW MANY BEDS DOES YOUR HOSPITAL PROVIDE Up to 150 151‑500 501‑1000 more than 1000 None, (not a hospital/clinic) 4 . WHAT SUBJECTS INTEREST YOU IN YOUR WORK? Surgical innovations/surgical equipment Radiology, imaging/high tech advances Clinical research/treatments/equipment Intensive Care Units/ management/equipment Ambulance and rescue equipment Pharmaceutical news Physiotherapy updates/equipment Speech therapy/aids Nursing: new aids/techniques Laboratory equipment, refrigeration, etc.. Hospital furnishings: beds, lights, etc. Hospital clothing and protective wear Hygiene & sterilisation Nutrition and kitchen supplies Linens & laundry Waste management Information technology & digital communications Hospital planning/logistics Personnel/hospital administration/management Hospital Purchasing Material Management Medical conferences/seminars EU political updates Other information requirements - please list ESPECIALLY FOR DOCTORS: Please complete the above questions and we would like you to answer the following additional questions by ticking yes or no or filling in the lines as appropriate. What is your speciality? In which department do you work? Are you head of the department? Yes No Are you in charge of your department’s budget? Yes No How much influence do you have on purchasing decisions? I can only present an opinion Yes No I tell the purchasing department what we need Yes No I can purchase from manufacturers directly Yes No Do you consider that your equipment is out-dated Yes No relatively modern Yes No state-of-the-art Yes No Do you use/buy second-hand equipment? Yes No If so, what do you use of this kind? Is your department linked to an internal computer network? Yes No Is your department linked to an external computer network? Yes No Is your department involved with telemedicine in the community? Yes No Do you consider your department is under-staffed? Yes No Are you given ample opportunities to up-date knowledge? Yes No Do you attend congresses or similar meetings for your speciality? Yes No This information will be used only in an analysis for European Hospital,Theodor-Althoff-Str. 45, 45133 Essen, Germany, and for the mailing out of future issues and the EH electronic newsletter. EUROPEAN HOSPITAL Reader Survey Signature Date EH 3/15 YOU may qualify for a FREE subscription to EUROPEAN HOSPITAL, the bi-monthly journal serving hospitals throughout the EU. *If selected, you will be sent a copy of EUROPEAN HOSPITAL every two months, as well as the EH electronic newsletter To participate, simply fill in this coupon and fax to: +49 201 87 126 864 Or post to: European Hospital Publisher Theodor-Althoff-Str. 45, 45133 Essen, Germany EUROPEAN HOSPITAL Vol 24 Issue 3/15 18 RADIOLOGY ‘Carrying out biopsies without imaging is like playing Battlesh A pathologist’s v of prostate diagn Report: Karoline Laarmann Pathology is the gold standard of prostate diagnostics. Whilst the radi- ologist makes interpretations based on shadows and grey scale values visible on an image, the patholo- gist has the ‘fait accompli’ under the microscope. Professor Glen Kristiansen, Director at the Institute for Pathology at the University Hospital Bonn, explains why image- guided biopsies also make sense from the pathologist’s point of view and why the prognosis for prostate cancer is a special case. No pathologist in Germany has published as many scientific works on the topic of prostate cancer as Glen Kristiansen. He believes that a qualified specialisation in specific organs, as is common in the USA, makes sense, but that it cannot be realised in Germany: ‘There is an increasing lack of qualified staff in pathology. When we look at how many pathologists per resi- dents Germany has, we’re in third place from the bottom, ahead only of Turkey and Poland. The situation is bound to get worse over the next few years as our field suffers from aging, recruitment problems and, to make matters worse, from require- ments planning.’ Kristiansen specifically wel- comes advances in imaging because these developments also lead to reduced workloads in pathology. He approves of the demand for image- guided prostate biopsies: ‘In every other case seen by pathologists the tissue sample is negative. However, we obviously never know whether the patient really is free of cancer or whether the biopsy was taken “blind” from the wrong area. This is like playing Battleship.’ The International Society of Urological Pathology introduced one important advance, from the pathol- ogist’s viewpoint, in November 2014. The Gleason-Score, i.e. infor- mation about the growth pattern, and therefore aggressiveness of a prostate cancer, was divided into five prognostic groups. Kristiansen explains why this is so important: ‘Most patients with prostate cancer are already of an advanced age. At the same time this cancer grows very slowly. So, the question is: Will the patient actually be alive for long enough to benefit from treatment or not?’ This group division helps to advise patients in a forward-looking manner. Over the last decades there have already been several shifts in para- digm regarding the prostate cancer treatment, the pathologist notes. ‘In the 1980s prostate cancer was still treated as some form of ‘senile wart’ occurring in men. The motto was: You die with prostate cancer but not because of prostate cancer. Therefore, it mostly wasn’t even treated. However, the available data has shown that there definitely are patients who die from this cancer. The pendulum swing then changed direction and the strategy was to find and treat as many cases of pros- tate cancer as possible.’ Although surgery and radiother- apy are treatment options, they are not without risks and side effects. A prostatectomy for instance can lead to incontinence and problems with potency and can therefore limit a patient’s quality of life significantly. The high prognostic significance of the Gleason-Score has turned it into an important parameter for treatment planning, but the problem of tumour heterogeneity remains – despite multiple, blind biopsies, as the aggressiveness of a cancer can be very different in different parts of a tumour. In this context the pathologist emphasises once more: ‘If we had image-guided pros- tate biopsies we could hold better, pre-therapeutic case conferences, where radiologists can present the Well-differentiated prostate cancer with a Gleason-Score of 3+3=6 Poorly differentiated prostate cancer with a Gleason-Score of 5+5=10. The poorly differentiated prostate carcinoma in the centre of this overview image, as well as on another image with higher magnification, shows a perineural invasion frequently occurring with all prostate cancers Source:Prof.Dr.GlenKristiansen Source:Prof.Dr.GlenKristiansen Source:Prof.Dr.GlenKristiansen Up to 150151‑500501‑1000 more than 1000 To participate, simply fill in this coupon and fax to: +4920187126864

EH 3_2015

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