Pathology and Laboratory Medicine Services
Ervin B. Shaw, MD
 

Laboratory Testing: Our laboratory has been deliberately arranged to function almost entirely as a 24-hour-per-day STAT laboratory, allowing for optimum laboratory monitoring of patients undergoing chemotherapy. Specialized testing for infections in immunocompromised patients is rapidly available on-site.

Transfusion Support: Predominantly supported by the American Red Cross Blood Donor Program, our transfusion service regularly meets the demand for transfusion products. Our program was one of the first in South Carolina to provide a hospital-based autologous transfusion service for preoperative deposits of one's own blood and re-transfusion as well as intra-operative autotransfusion. That is, we are fully capable of maximizing the usage of a patient's own blood.

Prostate Cancer: Aside from having developed, maintained and published an optimized procedure for handling the office-based prostate biopsies, we have emphasized the interpretation and utilization of the diagnostic information toward a highly dependable assessment of pretreatment stage and grade of prostate cancer. Diagnoses are faxed to the urologist's office by noon the next day. Through mapping of the biopsy findings and a unique presentation of the information to the radiologist, an ideal method is established for correlating the biopsy findings to those findings by endorectal-coil-MRI scanning and interpretation in our radiology department. This allows a fairly exact pretreatment determination of the prostate cancer stage. The patient is then better able to consider treatment alternatives with his urologist. If radical prostatectomy is performed, we thoroughly document the exact location and extent of the cancer within the resected specimen so that thorough evidence is available to consider any need for additional post-operative treatment.

Lung Cancer: Our hospital initiated a systematic approach to the evaluation of a patient with a lung mass in the fall of 1995. In January of 1996, this evolved into a very efficient concept of Center for Lung Evaluation and Treatment at the CLEAT Program. Though the program was discontinued, lung mass patients are supported by a maximized effort toward a focused and highly expeditious outpatient diagnosis for collaboration toward optimized treatment. Our department has devised processing techniques that have allowed us to make the correct diagnosis in an unusually high percentage of first attempts at either fine needle biopsy or bronchoscopic biopsy as outpatients.

Breast Cancer/GI Cancers: Our group employs special techniques to maximize the preservation and recovery of lymph nodes for a most accurate approach to cancer staging in radical resections. Office-based and hospital-based diagnostic needle aspirates and core biopsies are processed with a high degree of emphasis on accurate diagnosis and rapid transfer of the diagnosis to the treating physician. Diagnostic information on breast specimens is reported to the physician's office either the same day or next day. This same rapid- diagnosis system supports all breast specimens and breast fluid analysis, fine-needle aspirates, standard needle biopsies, stereotactic CT-guided biopsies, ultrasound guided biopsies and lumpectomies off all types. In November 2002 we instituted an "intense protocol for lymph nodes in breast and melanoma cases."

Pap Smears: This test has been the most successful cancer-screening test in history, and we have not yet found a "new" technique which can excel our cost- effective classical screening. Early in 2002, we implemented liquid-based sample processing. And mid-year 2002, we implemented supplementary robotic image analyzer screening of all cases (the 1st lab in South Carolina to do so).

Skin Cancer: Skin cancer can be variously treated by surgery or radiation therapy. For 20 years, our group has been involved in supporting doctors-office-based surgical treatment of ordinary and complicated skin cancers utilizing a pathology-specimen mapping technique that allows the surgeon to conserve as much normal skin as possible. Since a high percentage of skin cancers occur on the head and face, conservation of skin is highly important. As an alternative to either surgical resection or the staged removal of additional tissue to remove any remaining cancer, superficial or deeper (linear accelerator) x-ray therapy is available. Our program is one of the few in the state in which the radiation oncologist has the equipment and extensive experience to employ the skin-conserving method of superficial x-ray therapy.

Consultant Networking: Since 1972, we have steadily maintained relationships with world class experts for accurate cancer diagnosis and specification of rare types of cancer. Having emphasized optimal handling and processing of specimens in our lab, the opinions of these experts are only 24 hours away in any location in the USA. We began e-mail consults in 2004.

Online Resource: Our pathology group now provides a website, www.palpath.com, with over 400 pages of information (a great deal of it about cancer and our methods of working with and reporting on, cancer cases).  Use its search feature for any topic of interest.