FR-11 A HURRICANE REOPENS AN OLD WOUND

Abstract

You have accessJournal of UrologyHistory Forum1 Apr 2018FR-11 A HURRICANE REOPENS AN OLD WOUND Lawrence Wyner Lawrence WynerLawrence Wyner More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.3031AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In August 2017, the AUA Didusch Museum received a bundle of 184 original medical illustrations hurriedly packaged by a woman in St. Petersburg, Florida who wanted to preserve them from oncoming Hurricane Irma. These intricate charcoal sketches were the work of Miss Tod Dee Craig, who drew them over fifty years ago before she tragically took her own life. The drawings were the property of Dr. Perry B. Hudson, who had published many of them in his atlas of prostatic surgery in 1962 and again in his book on radical perineal prostatectomy in 1996 - the woman had taken care of him in his later years before he passed away in June 2017, just shy of his hundredth birthday. METHODS Dr. Hudson was an early proponent of the perineal approach for prostatic diagnosis and surgery. Not only was Dr. Hudson a staunch advocate of this technique, but he also continued to promote its use even after the mainstream urological community gravitated towards refining the retropubic approach. RESULTS A Navy veteran, Dr. Hudson was freshly trained from Johns Hopkins in 1951 when he accepted a position at the age of 33 at New York's newly-built Francis Delafield Cancer Hospital of Columbia University Medical Center. In the heady days of the post-war boom in scientific research, he designed a study to evaluate the utility of prostate cancer screening in a cohort of over a thousand men living in the "flophouses" of lower Manhattan's Bowery district. Many of these men were veterans suffering from PTSD, who had slid into homelessness through no fault of their own, during an era when there was no governmental safety net. Over the next 15 years, Dr. Hudson and his residents screened the volunteers for prostate cancer by performing open perineal prostate biopsies; those with cancer found on frozen section underwent simultaneous radical perineal prostatectomy along with aggressive hormonal therapy. CONCLUSIONS Dr. Hudson found an incidence of prostate cancer of 10% in this cohort. Overall mortality was 20% in the group with negative biopsies and 30% in the group diagnosed with prostate cancer who underwent treatment. His initial findings were published in major medical journals, and the study was even featured for the lay public in a 1958 Life Magazine spread; however, no one raised any ethical issues about it until 1966, when an editor at the journal Cancer challenged Dr. Hudson, and the study was terminated. More recently it has also been criticized on its design and the methods used to recruit subjects. Nonetheless, the Bowery series remains the first attempt to study a hypothesis which is still being hotly debated today; that is, that the early diagnosis and aggressive treatment of prostate cancer saves lives. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1244-e1245 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Lawrence Wyner More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...