FRII-15 THE BOWERY BIOPSIES: THE EXPLOITATION OF HOMELESS MEN TO ADVANCE PROSTATE CANCER DETECTION

You have accessJournal of UrologyHistory of Urology II (Moderated Poster)1 Apr 2014FRII-15 THE BOWERY BIOPSIES: THE EXPLOITATION OF HOMELESS MEN TO ADVANCE PROSTATE CANCER DETECTION Kari Bailey, Drew Palmer, and Shiv Patel Kari BaileyKari Bailey More articles by this author , Drew PalmerDrew Palmer More articles by this author , and Shiv PatelShiv Patel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1753AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives At the turn of the twentieth century, Dr. Hugh Young described the first open perineal prostate biopsy as well as the first radical prostatectomy for prostate cancer. By mid-century there had been little advancement in diagnosis of this disease. Dr. Perry Hudson, who trained under Dr. Young’s successor Dr. William Scott, recognized the need for detection of prostate cancer and implemented open perineal biopsy prior to prostatectomy for BPH. Hudson then desired to expand his research to men without benign enlargement. Methods A review was conducted on the history of prostate biopsy, the Bowery Series and Dr. Perry Hudson using PUBMED and JSTOR. Results In New York in 1951, Dr. Hudson started the Bowery Series, a study to advance prostate cancer detection. From 1951-1966, he recruited 1200 homeless, alcoholic men living in Bowery poverty housing to have open perineal prostate biopsies. Advertised as a symbiotic exchange, the study participants were lured into participation by the promise of comprehensive medical care. Once the men agreed to participate their meal tickets were withheld until they kept their appointments. The details of the study were not fully disclosed to the men and no written consents were signed. Many of the men were erroneously told they had an irregularity of their prostate and then offered an open biopsy with promise of a hospital stay and hot meals. After extensive pre-operative testing, the participant had an open perineal prostate biopsy and if the biopsy was positive they would proceed with radical prostatectomy. Additionally these participants were subject to surgical castration even though these invasive treatments were not routinely combined. Hudson published numerous studies with the Bowery series data. The major contribution to the field was proving the efficacy of prostate biopsy to detect prostate cancer at a treatable stage. Hudson stopped publishing data from the series when an editor inquired what measures he had taken to avoid legal ramifications. Conclusions The Bowery series was a large study that showed the effectiveness of prostate biopsy to diagnose potentially treatable prostate cancer. However, Hudson stated that this was not an appropriate means for prostate cancer screening, as healthy men should not be subject to such invasive means. The study was appallingly unethical as it subjected a vulnerable population to extremely radical treatment without appropriate informed consent. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e632 Advertisement Copyright & Permissions© 2014Metrics Author Information Kari Bailey More articles by this author Drew Palmer More articles by this author Shiv Patel More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...