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Trace elements: Innovative biopsy programs map how cancer spreads

Nature Medicine volume 22, pages 963–965 (2016)Cite this article

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Even though this patient had already died, there was no time to waste. So called 'rapid' or 'warm-body autopsies' serve a research purpose, and speed is necessary to capture and preserve RNA before it degrades. Unlike DNA, which is relatively stable, RNA breaks down quickly. The team has only a four- to six-hour window to mobilize and prepare for the arrival of the body to the morgue. They've had decades to perfect the routine. The program began at the University of Washington, Seattle, in 1991 to recover metastatic tissue from men who have died of prostate cancer. People often die at night, and so the rapid-autopsy teams are on call 24/7. Three teams of four people rotate being on call every few months. The teams are composed of a pathologist, such as True, a urology resident, tissue-acquisition specialists and several research technicians—one of whom carries autopsy tissue to the upstairs animal facility, and immediately initiates the process of grafting some of it into mice for further study. Their protocol never wavers. The pathologist begins by finding and removing metastatic tumors from soft tissue. Then, the pathologist drills into the same 20 sites of bone during each procedure to ensure collection of micrometastases and normal tissue. Bone is the most common site of metastasis for prostate cancer.

“This effort involves considerable investment, resources and willingness because you have to have a group of staff scientists willing to be on call, sometimes coming to the medical center at two o'clock in the morning,” says Colm Morrissey, a research scientist in urology who has been in the University of Washington program for 12 years. The University's rapid-autopsy program expanded recently to include bladder cancer because the type has been historically underfunded and understudied, he adds.

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  1. Jeanne Erdmann is an independent journalist in Wentzville, Missouri, who writes about science and health.,

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Erdmann, J. Trace elements: Innovative biopsy programs map how cancer spreads. Nat Med 22, 963–965 (2016). https://doi.org/10.1038/nm0916-963

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