About this page. This is a plain English summary of how Dr Kooner uses a special pathology test, called a frozen section, during prostate surgery. It does not replace medical advice from your own doctor or specialist.
For full information and references, please read the detailed page.
The problem we are solving
When the prostate is removed for cancer, the goal is to take it out cleanly, with no cancer cells at the cut edges. After the operation, the whole prostate is sent to the pathologist for detailed examination. The result usually takes two to three days.
If the pathologist later reports that there were cancer cells at the cut edge (a "positive margin"), it can be too late to go back and take out a bit more tissue.
What "frozen section" means
A frozen section is a quick pathology test. A small piece of tissue is sent to the pathology lab during the operation, frozen, sliced and looked at under a microscope. The result comes back in about 15 minutes, while the patient is still on the operating table.
How Dr Kooner uses this
Before the operation, a careful, systematic biopsy maps where the cancer is in the prostate. The operation is then planned around that map.
During the operation:
- If the prostate separates easily from the tissue around it, that is a good sign that the surgical plane is clear of cancer.
- If the tissue feels stuck, or hard to dissect, a frozen section is taken straight away to check whether cancer is at the edge.
- Frozen sections are also taken routinely from a few specific places where cancer often hides, such as the front of the prostate and the apex (the tip).
If a frozen section finds unexpected cancer at the edge, the surgeon can take a bit more tissue right then, instead of finding out two or three days later.
Why not every centre does this
This approach takes more work and needs a dedicated pathology team available during the operation. Not every centre offers it. Dr Kooner has worked with the same pathologist for thousands of cases, and the 15-minute turnaround does not slow the operation down.
Why patients value it
Most patients find it reassuring to know that the cut edges are being checked while they are still asleep, rather than days later. Published evidence shows that men who had unexpected cancer at the edge picked up by frozen section, and then had a bit more tissue removed straight away, can do as well as men whose cancer was fully removed at the first pass.
Important things to know
- Frozen section is a screening tool during surgery. It is not as detailed as the full pathology report, which still comes a few days later.
- The final pathology report is what guides any further treatment after surgery.
- Even with frozen sections, some men will still need a positive margin reported on final pathology, and may need additional treatment such as radiotherapy.
- This page is general information only. The right surgical plan for you should be decided with your own specialist.
What you can do next
- Read the full detailed page with references and the video.
- Short version: robotic prostatectomy - the operation itself.
- Short version: prostate biopsy - how the cancer is mapped before surgery.
- Request a second opinion on a treatment plan.
- Call 02 8382 6980 to make an appointment.