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April 30, 2018

In 'rapid autopsies,' hospitals race against time to untangle cancer’s secrets

Daily Briefing

    More hospitals are launching and expanding "rapid autopsy" programs: specialized programs that allow researchers to retrieve, sustain, and test cell samples in the minutes after a patient's death in hopes of finding treatments for cancer and other diseases, JoNel Aleccia writes for Kaiser Health News.

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    How 'rapid autopsies' work

    A rapid autopsy involves multiple tumor tissue samples from multiple locations throughout a patient's body soon after death, Aleccia writes. Because both RNA and DNA degrade quickly after death, it's best to obtain living cell samples within six hours of death and other samples within 12 hours.

    A single rapid autopsy may produce tissue samples for a half-dozen different researchers, who can then experiment with ways to treat or kill the cells.

    For instance, Sameek Roychowdhury, a medical scientist at Ohio State University's Comprehensive Cancer Center, said one rapid autopsy revealed that a cancer patient had developed a mutation that caused an experimental drug, known as an FGFR inhibitor, to stop working.

    "This is helping us shape how we develop this new drug," Roychowdhury said. "How can we make a better drug? Or can we make a better drug combination?"

    A rapid autopsy may also show a cancer changed as it spread through the body, according Roychowdhury. "Different parts of your body may have different cancer cells, even though they originated from the same cancer," he explained.

    Rapid autopsy technology has been around for decades, but in recent years more medical centers have adopted and expanded the programs, according to Jody Hooper, director of the Legacy Gift Rapid Autopsy Program at Johns Hopkins Medicine.

    According to Aleccia, at least 14 such programs exist in the United States. Most of those programs focus on cancer, but some medical centers are looking to expand the programs to other diseases, such as HIV. Hooper said the programs are primarily funded through cancer program funds, grants, and researcher fees—which means there's no cost to families, Aleccia writes.

    The unique challenges of a rapid autopsy

    Performing autopsies quickly after death can be difficult, as doing so requires a family to consent to the procedure within hours of their loved one's death. The practicalities can be challenging, too: Traffic and weather might prevent a body from being quickly moved to an autopsy facility, Aleccia writes.

    But terminal patients are often eager to participate in rapid autopsy programs, Hooper said. "They've made their peace with the outcome long before," said Hooper. Roychowdhury said that many patients "want to do something not only for themselves, but also to help others."

    Roychowdhury also said that he believes performing the autopsy is an honor. "This was once a living, breathing person that came into my office every other week," he said. "The thing I want to think about each day is that they've given so much so that others can benefit. Everyone has something to teach us after death" (Aleccia, Kaiser Health News, 4/26).

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