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Prostate
Q. What are the advantages of referring prostate biopsies to UroCor Labs for analysis?
A. UroCor Labs’ team of highly specialized
board-certified pathologists focus exclusively on the field of urological disease. In fact, UroCor Labs diagnoses 10% of all prostate cancer in the U.S. each year! Our pathologists’ Gleason Score results
have an 88% correlation with the radical prostatectomy Gleason Score. This level of accuracy makes our clients confident in the diagnoses UroCor Labs delivers. We understand the importance of
providing a definitive diagnosis and will provide one in 97% of the 50,000 prostate biopsies we review each year.
Q.
What is the value of the sextant approach to prostate biopsy? Is the sextant still the norm?
A.
The routine sextant is the systematic foundation for prostate biopsy. However, because prostate cancer is becoming more difficult to detect many urologists are utilizing strategies outside of the routine sextant biopsy to help locate tumors that might otherwise be missed. In fact, the current literature shows that 8, 10 or 12 core biopsy techniques enhance diagnostic yield and allow urologists to:
1. Significantly increase the likelihood of cancer detection in initial biopsies. In fact, the cancer detection rate can increase by as much as 19% over the routine
sextant. (From 80% for sextant to 99% -- Refer to the prostate biopsy section of our website for more information.)
2. Enhance rebiopsy procedures to detect cancer in high-risk
patients
3. Accurately perform the additional core extractions needed for patients exhibiting increased gland size.
Q.
What is the value of a systematic biopsy where each biopsy core is placed in an individual container, clearly labeled with the anatomic location?
A.
There are a number of advantages to identifying the prostate gland site of each biopsy taken which include:
nPlanning treatment
i. Helps more effectively use “bonus” brachytherapy seeds
ii. Helps plan for modification of surgical strategy involving nerve sparing surgery and surgical margins.
nDirect rebiopsy strategy
i. Allows the urologist to more thoroughly sample sectors known to contain High Grade PIN, suspicious glands or small cancer foci
nPredict disease relapse after therapy
nImproves pathology processing by helping to prevent missing segments due to tangling of multiple cores
nAssures better representation of Gleason Score by providing more accurate depiction of multifocal prostate cancer heterogenity
UroCor Labs SextantPlus
prostate biopsy histology kit provides an increased level of flexibility to accommodate many of these new emerging biopsy strategies in practice today. By placing each biopsy core into a separate container,
you will receive from UroCor Labs a more comprehensive report to help guide your patient work-up and treatment decisions. The SextantPlus prostate biopsy histology report has a number of key features including:
nAt-a-glance diagnosis and case summary
nFlexible graphic depiction of areas biopsied
nGleason
score and percentage tumor involvement for each malignant area
nCancer diagnosis highlighted in red
Q. Who can order UroCor’s laboratory services?
A. Only physicians or other qualified health care providers can order UroCor’s laboratory services.
Q.
Does Medicare and other insurance cover all the services provided by UroCor Labs?
A.
No. Medicare and many other insurance payors will only pay for a service if the service is covered, reasonable and medically necessary for the beneficiary, given his or her clinical condition. The obligation to determine what tests are medically necessary and appropriate rests with the patient’s physician, not with UroCor Labs.
Q. What type of fixative is used?
A.
UroCor Labs uses a 10% neutral buffered formalin as a fixative for prostate histology specimens. This is a fixative used for most tissues which preserves tissue without drying it out.
Q.
Does UroCor Labs read slides for 2nd opinions?
A. Yes.
Q. How can a urologist’s practice arrange for UroCor Labs to send slides to another pathologist for a second opinion?
A.
Call UroCor Labs Client Relations at 1-800-411-1839 to arrange for a second opinion.
Bladder
Q. Who can order UroCor’s laboratory services?
A. Only physicians or other qualified health care providers can order UroCor’s laboratory services.
Q. Does Medicare and other insurance cover all the services provided by UroCor Labs?
A.
No. Medicare and many other insurance payors will only pay for a service if the service is covered, reasonable and medically necessary for the beneficiary, given his or her clinical condition. The obligation to determine what tests are medically necessary and appropriate rests with the patient’s physician, not with UroCor Labs.
Q. What is the difference between microhematuria analysis and cytology?
A.
Cytology can be used to either confirm or rule out bladder cancer. Microhematuria, in most cases, is used only to rule out bladder cancer and to provide the requesting physician information about the source of the hematuria for a particular patient.
Q. Why do I need cytology when I cystoscope my patients?
A.
While cystoscopy is the gold standard it is not 100% sensitive. Several studies have placed the sensitivity of cystoscopy at 70-80%. Cystoscopy cannot access the upper track or diverticula. In addition there are over 20 benign tumors that look like malignant tumors. Because physicians do not usually biopsy in their office, a cytology can assist in analyzing the tumor.
Q. Why not 1st morning void for cytology?
A.
Cells that sit over night in the bladder degrade and are not optimal for interpretation. While our pathologists prefer not to have a first morning void, we will accept this type of specimen.
Q.
How much volume does UroCor Labs require for cytology?
A.
A minimum of 100ml is optimal-- 50% urine specimen and 50% liquid fixative. If less volume is received UroCor will attempt to run as many tests which have been ordered as it can.
Q. Can the urine specimen be stored overnight?
A. A fixed urine specimen can be stored overnight. It is preferable to store the specimen in a refrigerator.
Q. Do I need to send tissue to get a p53 result?
A. No, UroCor Labs proprietary p53 analysis can be run off of a simple urine specimen.
Managed Care
Q. Who can order UroCor’s laboratory services?
A. Only physicians or other qualified health care providers can order UroCor’s laboratory services.
Q. Does Medicare and other insurance cover all the services provided by UroCor Labs?
A.
No. Medicare and many other insurance payors will only pay for a service if the service is covered, reasonable, and medically necessary for the beneficiary, given his or her clinical condition. The obligation to determine what tests are medically necessary and appropriate rests with the patient’s physician, not with UroCor Labs.
Q. Is there someone to call if I have an immediate question?
A. Please call UroCor Labs Client Relations Department with any questions at 1-800-411-1839.
Q.
Does UroCor Labs bill primary and secondary insurances?
A. Yes. UroCor Labs routinely bills primary and secondary insurances when complete and accurate information is provided on the test requisition.
24-Hour Urine
Q. Who can order UroCor’s laboratory services?
A. Only physicians or other qualified health care providers can order UroCor’s laboratory services.
Q. Does Medicare and other insurance cover all the services provided by UroCor Labs?
A.
No. Medicare and many other insurance payors will only pay for a service if the service is covered, reasonable and medically necessary for the beneficiary, given his or her clinical condition. The obligation to determine what tests are medically necessary and appropriate rests with the patient’s physician, not with UroCor Labs.
Q. How does each analyte relate to treatment?
A. This information is provided in UroCor Labs diagnostic report as well as the customized patient education.
Q.
What general treatment can be suggested to prevent stones without stone identification?
A. A balanced diet and appropriate level of hydration, especially for recurrent stone formers.
Q.
What is the recommended protocol for the appropriate number of 24-hour urines and monitoring schedule?
A.
Two 24-hour urine samples from a patient who has passed a stone in order to establish a baseline. After the baseline is established, the patient is treated. When treatment is complete, a third 24-hour urine is done to identify any changes relative to the baseline.
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