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Prostate biopsy infections dropped tenfold

Prostate biopsy infections dropped tenfold

Dr. Chris Morash leads the Community of Practice for prostate cancer, which has developed regional standards so that patients across Eastern Ontario get consistent and high-quality surgical care.

When a patient goes for a prostate cancer biopsy, he takes an antibiotic before the procedure to stave off infection. But, if the bacteria he encounters are antibiotic resistant, he could still get very sick.

The Community of Practice (CoP) for prostate cancer, led by The Ottawa Hospital, saw this problem happening across the Champlain region and used its expertise to develop a tailored, regional protocol.

“What works in other regions doesn’t necessarily work here,” said Dr. Chris Morash, Medical Director of The Ottawa Hospital’s Prostate Cancer Assessment Centre. “But we can predict antibiotic resistance for our region so we tailored the antibiotics patients take before a biopsy.”

Within months of launching the new protocol, said Dr. Morash, the number of patients who developed infections after a biopsy dropped tenfold.

The CoP – a collective of health-care professionals from across the region and part of the regional Surgical Oncology Program – has met regularly since 2007 to discuss specific issues in prostate cancer surgery and treatment, aiming to improve and standardize care.

“We looked at the entire region and saw that patients who go to different hospitals for the same surgery would get different treatments: different antibiotics, lengths of stay, blood-clot prevention and many other differences in treatment style,” said Dr. Morash. “We thought we should look at the evidence, collectively design the best practice, and do it the same way across the region.”

Eight years later, the CoP continues to focus on encouraging patient-centred oncology care by improving the side effects of surgery.

In the operating room, surgeons often remove additional healthy tissue to ensure no cancerous cells are left behind. Although effective, this can leave patients with life-long side effects.

For the past year, patients have been asked to report factors like urinary incontinence and sexual function before surgery and then again six, 12 and 24 months after. Surgeons are given score cards with data from patients so that they can have a clearer idea of what impact their surgical choices have.

“In prostate cancer surgery, side effects are related to quality of life,” said Dr. Morash. “We want to improve our surgical quality to help our patients live long and happy lives with fewer side effects.”


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