John McNeal, expert on prostate structure, dies at 75

John E. McNeal

John E. McNeal, who pioneered the classification and documentation of prostate cancer, died Nov. 3, 2005, after a 16-year battle with chronic lymphocytic leukemia. He was 75.

During his 22 years at Stanford, McNeal examined and cataloged more than 1,000 cancerous prostates removed by urologists. He took slices of the tissue and studied each under a microscope. He then sketched the cancerous areas and other pathologic features on paper for future reference.

A number of staff urologists took advantage of McNeal's meticulous records. Professor of urology Thomas Stamey, MD, used them to track whether there was any correlation between the amounts of prostate cancer seen and the PSA test, a widely used blood test used to diagnose prostate cancer. In 2004, Stamey and his colleagues published findings that the test is no longer predictive, touting the end of the "PSA era."

"John McNeal was unique among pathologists," said Stamey. "He created a scientific treasure for my laboratory that we will rely upon for years to come. His acute insights literally made the prostate come alive under the microscope."

McNeal's recognition and description of the three anatomical zones of the prostate changed the way physicians worldwide view the prostate gland. He once remarked that the prostate, both malignant and normal, had "a tremendous variety of architectural forms, in contrast to other organs which are rather dull, with everything looking the same."

McNeal graduated from George Washington University School of Medicine in 1957 and was elected to the Alpha Omega Alpha Medical Honor Society that same year. He completed his residency in pathology at UC-San Francisco in 1962.

Following residency, McNeal pursued a career in private practice in the East Bay. His writings on the structure of the prostate gland gained him recognition in the academic community. In 1983, Stamey convinced him to join the faculty, where he was a clinical professor and senior research associate in the Department of Urology until 2005. For many years, despite being debilitated by chronic illness, he continued to make important observations on the prostate.

McNeal's landmark contributions to the understanding of prostate anatomy and prostate cancer pathology gained him the 1992 Prostate Cancer Award of the American Urological Association. He was author of 129 articles, including "Zonal anatomy of the prostate," in which he defined the structure of the prostate as it is still known today.

"Aside from his enormous contributions to medicine, John is remembered within the department for the twinkle in his eye, his smile and understated modesty," said Linda Shortliffe, MD, the chair of urology and the Stanley McCormick Memorial Professor in the School of Medicine. "He is greatly missed, but his legacy lives."

McNeal is survived by his wife, Barbara, and three step-daughters: Claudia Franceschi, Mary Redwine and Elise Redwine Wells, who assisted him in his work from 1984 through 1992.