DOCSLIB.ORG

Prostate Cancer UK: the Blue Skies Forum

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Prostate Cancer UK: the Blue Skies Forum Kirby Blue Skies_Layout 1 19/11/2013 10:42 Page 1 REPORTS 39 Prostate Cancer UK: the Blue Skies Forum ROGER KIRBY, ROS EELES, DAVID NEAL, HASHIM U. AHMED AND DAVID DEARNALEY The second meeting of the Blue Skies Forum took place in Downing College, Cambridge, in April 2013, with the objective of focusing attention on new initiatives in the diagnosis and treatment of prostate cancer, in particular on areas of research that aim to identify aggressive disease. The meeting was hosted by Prostate Cancer UK and supported by The Howard Foundation. GENETIC PREDISPOSITION TO the top 1 per cent of the risk distribution PROSTATE CANCER AND had a 4.7-fold risk relative to the CLINICAL APPLICATION population average and the top 10 per Professor Ros Eeles cent of men had a 2.7-fold relative risk. Interestingly, one of the variants on Prostate-specific antigen has been used as chromosome 17, while increasing the risk a biomarker in prostate cancer since its of prostate cancer, decreases the risk of identification in 1974, but is not sensitive diabetes. The increase in risk with each enough to identify those patients at risk variant is small but the overall effect is of developing high-risk disease. Genetic multiplicative. The detection of these variants have now been identified that variants has the potential for identification can recognise men with nearly a five-fold of targeted drug therapy by discovering relative risk of developing prostate cancer the pathways within which the genes act. compared with the risk to the average man Certain pathways are over-represented in the population. within the genetic variants, such as the Prostate Cancer UK is a registered charity in England pathway for cell adhesion, extracellular and Wales (1005541) and in Scotland (SC039332). Registered company 2653887 A case-control study has been set up matrix modelling and, unsurprisingly, involving 61 research groups worldwide, transcriptional regulation by the androgen Roger Kirby, The Prostate Centre, London; called the PRACTICAL consortium, and receptor (AR). Ros Eeles, Professor of Oncogenetics, the genotyping of 25074 prostate cancer Institute of Cancer Research and cases and 24272 controls from 39 of these Previously, BRCA2 germline mutations have Royal Marsden NHS Foundation Trust; 1 groups has been published. A total of 23 been shown to confer the highest risk of David Neal, Professor of Surgical new prostate cancer loci were identified, prostate cancer (8.6-fold in men aged Oncology/Honorary Consultant Urological 2 16 of which are associated with aggressive ≤65 years), while mutations in BRCA1 Surgeon, Addenbrooke’s Hospital, 3 disease (Figure 1). These and other confer a 3.7-fold risk. Additionally, BRCA2 Cambridge; Hashim U. Ahmed, Clinician discovered loci now explain 30 per cent mutations have been associated with Scientist, University College London; of the familial risk for the disease. aggressive tumour phenotype and poor David Dearnaley, Professor of Uro-oncology, 4 prostate cancer outcome. Further research Institute of Cancer Research and Royal On the basis of combined risks conferred on the involvement of these mutations Marsden NHS Foundation Trust, London by the new and previously known risk loci, has been published recently.5 Germline TRENDS IN UROLOGY & MEN’S HEALTH NOVEMBER/DECEMBER 2013 www.trendsinurology.com Kirby Blue Skies_Layout 1 19/11/2013 10:42 Page 2 REPORTS 40 castrate-resistant prostate cancer (CRPC): 53 cancer cells may act as their synthesisers of androgens; there may be cross-talk 48 signalling via several receptors; the AR may be amplified; and there may be altered 43 expression of transcription factors and 38 co-regulators, which could affect AR binding and signalling. These changes 33 may be present in the early stages of the disease. 28 value) Studies have been conducted to examine p ( 23 10 to which genes the AR binds in the nucleus –log 18 and the functional effects. The method used involves binding of the AR to the 13 genome and then disruption of the DNA and sequencing of specific binding sites. 9 In cell lines, AR binding was shown 6 to co-ordinate a metabolic response promoting aerobic glycolysis.9 A number of 3 novel genes being regulated by AR were identified, including calcium/calmodulin 0 kinase kinase 2 (CAMKK20), which is implicated in the regulation of energy 1 2 3 4 5 6 8 1012141720 XY balance and overexpressed in hormone- Chromosome naïve prostate cancer, but is absent following hormone treatment, reappearing Figure 1. Manhattan plot showing 23 genetic loci associated with increased risk of 9 prostate cancer1 when CRPC develops. CAMKK20 is a potential drug target and inhibition by BRCA1/2 mutations were shown to be Future research includes the recently STO-609 results in inhibition of prostate more frequently associated with Gleason initiated PROFILE study, which will examine cancer growth.9 ≥8 (p=0.00003), T3/T4 stage (p=0.003), the feasibility of targeted prostate cancer nodal involvement (p=0.00005) and screening of men with familial history of Sequencing studies have been conducted metastases at diagnosis (p=0.005) than prostate cancer through prostate biopsy in benign prostate tissue samples and prostate cancer in non-carriers. Cancer- and association of the outcome with prostate cancer tissues from patients who specific survival (CSS) was significantly genetic risk profiling. were untreated, were responders to longer in non-carriers than in carriers androgen deprivation therapy (ADT) or had (15.7 versus 8.6 years). In localised prostate ANDROGEN RECEPTOR CRPC, in order to identify AR binding cancer, five-year CSS and metastasis-free BINDING SITES IN PROSTATE sites.10 The PSA gene was identified as a survival were significantly higher in CANCER binding site, as well as FKBP5, CAMKK2, non-carriers (96 versus 82 per cent Professor David Neal TMPRSS2 and PGC. The AR appears to [p=9 x 10-8] and 93 versus 77 per cent be reprogrammed in CRPC. Unique AR [p=0.0001], respectively). The AR plays a key role in prostate binding sites at E2F, STAT and MYC/MAX growth; subsequent to binding to were identified that were not observed Another genetic association is mutation dihydrotestosterone, it moves into the in cell lines, resulting in the switching in the HOXB13 gene, which is associated nucleus of the prostate cell to initiate a on of the JAK/STAT pathway. A series of with limb structure and androgen biological response through DNA binding. 16 genes have been identified that are signalling, and has been shown to The AR is an important oncogenic driver in upregulated in CRPC and are actually increase the risk of prostate cancer prostate cancer and is reprogrammed in present at diagnosis prior to ADT.10 These 3.63- to 8.66-fold. It is more common high-risk disease. A number of mechanisms genes will provide potential targets for in the Scandinavian population.6–8 may be involved in the development of future therapy. www.trendsinurology.com TRENDS IN UROLOGY & MEN’S HEALTH NOVEMBER/DECEMBER 2013 Kirby Blue Skies_Layout 1 19/11/2013 10:42 Page 3 REPORTS 41 INNOVATION IN SURGICAL THERAPY FOR PROSTATE 35 80 Resonant frequency CANCER 30 Temperature from fluoroptic probe Mr Hashim U. Ahmed 60 25 (°C) Temperature It has been established that not all prostate cancer has the potential to progress to 20 40 invasive and metastatic cancer, and novel 15 imaging and precision biopsy might allow 10 identification of those lesions that are 20 likely to progress and require treatment. 5 To this aim, focal therapy of prostate Resonant frequency change (Hz) cancer has been proposed as an alternative 0 0 that will tailor treatment with consequent -5 minimisation of treatment morbidity. -20 0 20 40 60 80 100 120 A total of 24 focal therapy studies have Time (s) been conducted involving cryosurgery (n=6), high-intensity focused ultrasound Figure 2. Graph illustrating how quickly the heating of tissue can occur for thermoablation when a magnetic field is applied to iron oxide nanoparticles (n=12), photodynamic therapy (n=3), radiofrequency interstitial tumour ablation achieved in the prostates; median urethral TOWARDS PRECISION AND (n=1), brachytherapy (n=1) and mixed and rectal temperatures were 40.5°C PERSONALISED ablation (n=1). Most studies were poorly (range: 38.4–43.6°C) and 39.8°C (range: RADIOTHERAPY reported, retrospective in design and at 38.2–43.4°C), respectively. Computed Professor David Dearnaley an early phase. Overall, complications tomography scans revealed that the and side-effects were low but studies particles stayed within the prostate. A Radical changes in radiotherapy have been struggled to define disease control phase 0 study on magnetic nanoparticle made over the past 10 years through outcomes, although biopsy outcomes thermoablation is to be conducted at improvements in imaging, precision appeared variable. An increasing number University College London involving engineering and increased computational of prospective studies on focal therapy 18 men prior to radical prostatectomy. speeds. This has allowed the development of are now underway, with the UK leading Nanoparticles will be injected into the two different concepts of radiotherapy, many of these. prostates and placement evaluated to namely intensity-modulated radiotherapy determine whether the necessary particle (IMRT) and image-guided radiotherapy Current ablative technologies are not density needed to reach a therapeutic (IGRT), which provide very accurate perfect, and ongoing research to improve temperature can be achieved. The target treatment. Still lacking in our current the care of men with localised prostate temperature is 70°C with the application of knowledge is individual tumour sensitivities cancer is needed. Magnetic nanoparticle 100s of current. A phase 1 study will also to radiotherapy, primarily due to lack of thermoablation has been researched as a be conducted to examine the ablative access to tissue samples.
Load more

Recommended publications
  • How to Avoid the Seven Deadly Sins of Surgery
    INTRODUCTION HOW TO AVOID THE ‘ SEVEN DEADLY SINS OF SURGERY ’ † † Roger Kirby * , Ben Challacombe * , Prokar Dasgupta * and Increasingly, especially as surgeons, we live ‡ † in a world where the hue and cry resulting John M. Fitzpatrick – * The Prostate Centre , and Department of Urology, MRC from one single untoward incident can Centre for Transplantation, Guy ’ s Hospital, King ’ s College London, King ’ s Health Partners, drown out the plaudits that ought to be due London, UK , and ‡ Mater Misericordiae Hospital and University College Dublin, Dublin, Ireland for literally thousands of cases that have Accepted for publication 14 September 2011 gone smoothly. As a result, it is essential for each and every one of us to try by every means possible to avoid medical accidents, errors and untoward incidents. And when they do occur, we need to deal with their to the patient and his or her relatives, with A similar failure to appreciate what is really aftermath calmly and professionally. follow-up meetings, can avoid months, if happening may arise in the operating not years, of anxiety-inducing litigation. theatre. If advice from the team, including Looking back over seven decades of the assistant, the anaesthetist, the scrub combined experience in urological surgery, The increased focus on teaching these nurse and even the medical student is we thought it might be useful to consider non-technical skills aims to improve factored in, it can sometimes help to avoid a the seven key lessons (mainly learned the standards of communication [ 1 ] . The launch fatal error being made. An operation with hard way) in an attempt to help others of the BAUS national simulation program, ‘ unusual anatomy ’ often suggests that a avoid falling into the traps that lurk in wait SIMULATE, should achieve standardisation of surgeon is in the wrong tissue plane or for the unwary.
    [Show full text]
  • Ilk Sayfalar 7/6/04 14:13 Page 1 ANDROLOJ‹ BÜLTEN‹
    ilk sayfalar 7/6/04 14:13 Page 1 ANDROLOJ‹ BÜLTEN‹ TÜRK ANDROLOJ‹ DERNE⁄‹ YAYIN ORGANIDIR Türk Androloji Derne¤i Cemil Aslan Güder Sok. ‹dil Ap. B Blok D.1 80280 Gayrettepe, ‹stanbul Tel: 0212 288 50 99 Faks: 0212 288 50 98 E-posta: [email protected] Web: www.androloji.org.tr TÜRK ANDROLOJ‹ DERNE⁄‹ ADINA SAH‹B‹ Prof. Dr. Atefl Kad›o¤lu GENEL YAYIN YÖNETMEN‹ Uz. Dr. Memduh Ayd›n REDAKTÖR Uz. Dr. Ertan Sakall› YÖNET‹M KURULU Atefl Kad›o¤lu (Baflkan) Bülent Semerci (Genel Yazman) ‹rfan Orhan (Sayman) Ramazan Aflç› (Üye) M. Önder Yaman (Üye) Selahittin Çayan (Üye) Mustafa F. Usta (Üye) Nisan 2004 Say› 17 2 Ayda Bir Yay›nlan›r ilk sayfalar 7/6/04 14:14 Page 2 GENEL YAYIN YÖNETMENİ REDAKTÖR Uz. Dr. Memduh Aydın Uz. Dr. Ertan Sakallı BİLİMSEL KURUL ERKEK CİNSEL SAĞLIĞI Yaşlılık ve Cinsellik Ejakülasyo PrekoksRekonstrüktif Cerrahi ED ve Farmakoterapisi Doç. Dr. Ali Atan Prof. Dr. Ahmet Metin Prof. Dr. Erdal Apaydın Uz. Dr. Ertan Sakallı Uz. Dr. Melih Beysel Temel Araştırma Psikolojik ED Doç. Dr. Emin Özbek Yrd. Doç. Dr. Hakan Kılıçarslan Yrd. Doç. Dr. Mustafa Faruk Usta Doç. Dr. Doğan Şahin INFERTİLİTE Varikosel Endokrinoloji Doç. Dr. Selahittin Çayan Uz. Dr. Necati Gürbüz Doç. Dr. Turhan Çaşkurlu Doç. Dr. İsa Özbey Yardımla Üreme Teknikleri Genetik Prof. Dr. Kaan Aydos Doç. Dr. Barış Altay Uz. Dr. Lütfi Tunç Uz. Dr. A. Arman Özdemir Yrd. Doç. Dr. Murat Şamlı Obstrüktif İnfertilite Kadın İnfertilitesi Doç. Dr. Hamdi Özkara Doç. Dr. İrfan Orhan Prof. Dr. Cihat Ünlü Doç. Dr. Erkut Attar Pediatrik Androloji Androloji Laboratuarı Doç.
    [Show full text]
  • That Silly Operation! the Introduction of TURP Into Great Britain
    That Silly Operation! The introduction of TURP into Great Britain Jonathan Charles Goddard 1 Jonathan Charles Goddard Curator of the Museum of Urology, BAUS Consultant Urological Surgeon Leicester General Hospital Acknowledgements I’m very grateful to Mr Bernard Ferrie FRCS, retired Urological Surgeon, who acted as expert editor. Thanks to Miss H.P.H. Goddard, Junior Curator, for photographing the instruments from the collection. I’m extremely grateful to KARL STORZ Endoscopy (UK) Ltd. who generously published this booklet for the 2019 BAUS Annual Meeting in Glasgow. 2 “That Silly Operation!” The introduction of TURP into Great Britain “We want you to give up that silly TURP operation John, it will bring St Peter’s into disrepute”. This is what John Blandy, one of the icons of Twentieth Century British Urology, was told by his “greaters and betters” at St Peter’s Hospital (the famous London urology centre) as late as the 1960’s[1]. TURP even at that stage was still seen as a “silly” new and dangerous operation that should not replace open prostatectomy. However, Transurethral Resection of the Prostate, TURP, is now seen as one of the operations that define Urology. Certain procedures, over time, have stood out as key indicators of Urology; lithotomy, lithotrity, cystoscopy, open prostatectomy, radical prostatectomy and now robotic prostatectomy. They are each surgeries of their age, their names associated with Urology and even certain urologists. A brief roll call of names are easily linked with each one; Cheselden (lithotomy), Civiale and Sir Henry Thompson (blind lithotrity), Nitze and Hurry Fenwick (Cystoscopy), Sir Peter Freyer (open prostatectomy), Patrick Walsh (Radical Retropubic Prostatectomy), Roger Kirby and Prokar Dasgupta (Robotic prostatectomy in the UK).
    [Show full text]
  • Urethro-Vesical Dysfunction in Progressive Autonomic Failure with Multiple System Atrophy
    Journal of Neurology, Neurosurgery, and Psychiatry 1986;49:554-562 Urethro-vesical dysfunction in progressive autonomic failure with multiple system atrophy ROGER KIRBY,* CLARE FOWLER,* JOHN GOSLING,t ROGER BANNISTER$ From the Department of Urology, Middlesex Hospital,* London, The National Hospitalfor Nervous Diseases, London, and the Department ofAnatomy, University ofManchester,t UK SUMMARY Fourteen patients with progressive autonomic failure and multiple system atrophy have been investigated by urodynamic, electromyographic and neurohistochemical means and the results compared with a series of age-matched controls. Three fundamental abnormalities of lower urinary tract function have been identified: (1) Involuntary detrusor contractions in response to bladder filling. It is suggested that these may be the result of a loss of inhibitory influences from the corpus striatum and substantia nigra. (2) Loss of the ability to initiate a voluntary micturition reflex. This may reflect the degeneration of neurons in pontine and medullary nuclei and in the sacral inter- mediolateral columns. In addition, these studies have demonstrated a significant reduction in the density of acetylcholinesterase-containing nerves in bladder muscle. (3) Profound urethral dys- function. This appears to be partly due to a loss of proximal urethral sphincter tone, which causes bladder neck incompetence. In addition, the function of the striated component of the urethral sphincter is impaired. Individual motor units recorded from this muscle were clearly abnormal when compared with controls and suggested that reinnervation had occurred. We suggest that this is the result of degeneration of a specific group of sacral anterior horn cells known as Onuf's nucleus. The evidence that these particular motor units are affected, while others are spared, poses fundamental questions about the nature of selective vulnerability in degenerative diseases of the nervous system.
    [Show full text]
  • University of Birmingham So Much Cost, Such Little Progress
    University of Birmingham So Much Cost, Such Little Progress Bryan, Richard T; Kirby, Roger; O'Brien, Tim; Mostafid, Hugh DOI: 10.1016/j.eururo.2014.02.031 License: Creative Commons: Attribution-NonCommercial-NoDerivs (CC BY-NC-ND) Document Version Peer reviewed version Citation for published version (Harvard): Bryan, RT, Kirby, R, O'Brien, T & Mostafid, H 2014, 'So Much Cost, Such Little Progress', European urology, vol. 66, no. 2. https://doi.org/10.1016/j.eururo.2014.02.031 Link to publication on Research at Birmingham portal Publisher Rights Statement: Checked October 2015 General rights Unless a licence is specified above, all rights (including copyright and moral rights) in this document are retained by the authors and/or the copyright holders. The express permission of the copyright holder must be obtained for any use of this material other than for purposes permitted by law. •Users may freely distribute the URL that is used to identify this publication. •Users may download and/or print one copy of the publication from the University of Birmingham research portal for the purpose of private study or non-commercial research. •User may use extracts from the document in line with the concept of ‘fair dealing’ under the Copyright, Designs and Patents Act 1988 (?) •Users may not further distribute the material nor use it for the purposes of commercial gain. Where a licence is displayed above, please note the terms and conditions of the licence govern your use of this document. When citing, please reference the published version. Take down policy While the University of Birmingham exercises care and attention in making items available there are rare occasions when an item has been uploaded in error or has been deemed to be commercially or otherwise sensitive.
    [Show full text]
  • Queen Square Alumnus Association
    QUEEN SQUARE ALUMNUS ASSOCIATION Issue 4 December 2012 Editor Mr David Blundred Teaching and E-Learning Administrator [email protected] Editorial Leads Professor Simon Shorvon Professor Andrew Lees Miss Jean Reynolds Ms Daniela Warr Schori Miss Pat Harris Professor Ian McDonald dŚĞ ŽƉŝŶŝŽŶƐ ĞdžƉƌĞƐƐĞĚ ŝŶ ƚŚĞ ŶĞǁ ƐůĞƩ Ğƌ ďLJ authors and interviewees do not necessarily reflect the opinion of the Editor or the UCL /ŶƐƟƚƵƚĞŽĨE ĞƵƌŽůŽŐLJĂŶĚE ĂƟŽŶĂů, ŽƐƉŝƚĂůĨŽƌ Neurology and Neurosurgery. All photographs have been kindly provided by D ĞĚŝĐĂů/ůůƵƐƚƌĂƟŽŶ͕ Y ƵĞĞŶ^ƋƵĂƌĞ>ŝďƌĂƌLJĂŶĚ ƚŚĞĚŝƚŽƌƐƉƌŝǀ ĂƚĞĐŽůůĞĐƟŽŶ͘ Contents Editorial 02 News 03 Queen Square Alumnus A round-up of the latest news Association meeting 2013 from Queen Square Alumni News 09 Queen Square Alumnus Association Meeting 11 News, views and recollections from Programme details your fellow alumni Upcoming Events 12 Queen Square Interview 13 A sample of events on offer The Editor interviews Professor Clare over the next few months Fowler on her career at Queen Square Alumni Interview 18 The Editors Travels 20 Dr Andreas Moustris talks about his time at Queen Square An update on the Editors Travels Focus on the Dominican Republic 21 Wilsons Disease Centenary Symposium 23 Professor Jose Puello updates us on developments Professor Niall Quinn and Dr Ted Reynolds in the Dominican Republic speak about this event Out of the Archives 26 Photos from our Archives 28 Christmas recollections from 1906 A look at some of our photos from our archives Belfast Neurology 30 Front Cover Explained 33 Dr Stanley Hawkins talks about Neurology in the Nineteenth and A look at the front cover Early Twentieth Century 1 EDITORIAL The Queen square Alumnus Association Meeting July 2013 I am delighted to announce that we will be holding a two day Alumnus meeting on the 8th and 9th July 2013.
    [Show full text]
  • Nerve Advancement with End-To-End Reconstruction After Partial Neurovascular Bundle Resection:A Feasibility Study
    JOURNAL OF ENDOUROLOGY Volume 21, Number 8, August 2007 © Mary Ann Liebert, Inc. DOI: 10.1089/end.2007.9946 New Technology Nerve Advancement with End-to-End Reconstruction after Partial Neurovascular Bundle Resection:A Feasibility Study JUAN I. MARTINEZ-SALAMANCA, M.D.,1 SANDHYA RAO, M.D.,1 RAJAN RAMANATHAN, M.D.,1 JAVIER GONZALEZ, M.D.,2 ANIL MANDHANI, M.D.,1 XIMING YANG, M.D.,1 JIANGLING TU,1 E. DARRACOTT VAUGHAN, M.D.,1 and ASHUTOSH TEWARI, M.D.1 ABSTRACT Background and Purpose: It is clear that some patients with prostate cancer require a total or partial neu- rovascular bundle (NVB) resection for oncologic safety to be guaranteed. Nerve grafting is an alternative for these patients to maintain erectile function; however, we report on a feasible option where the NVB is re- leased, and both terminal nerve fibers are approximated; this is the “nerve advancement technique (NAT).” Patients and Methods: Since 2005, a total of 215 men aged 48 to 70 years (mean 59 years) with a Sexual Health Inventory for Men (SHIM) score of 22 have undergone robotic radical prostatectomy for cancer. We selected prospectively seven men to have NAT performed because of clinical high-risk criteria (serum prostate specific antigen [PSA] concentration Ͼ20 mg/dL, Gleason score ϭ 8, and stage cT2c or higher), intraopera- tive criteria (difficulty separating the tissues around the prostate), and evidence of extracapsular extension (ECE) on magnetic resonance imaging. We performed unilateral partial resection, nerve advancement, and, finally, end-to-end anastomosis in six patients, whereas in one patient, we did a bilateral partial excision.
    [Show full text]
  • Prostate Cancer and Diet Update Study Conclusion
    prostate matters Newsletter of the Prostate Cancer Support Federation Issue 7 February 2010 Contents New Year, new layout Page 2 Report of the Great PSA Debate and a sponsor for our Page 3 PSA Debate continued Page 4 Prostate Cancer and new all colour newsletter! Diet Update Page 5 Diet and Lifestyle The Prostate Cancer Support Federation Changes Page 6 RADICALS Annual Conference & AGM Clinical Trial Page 7 The Great PSA Debate Questionnaire Analysis Report Living well with Page 8 National Cancer Patient Information Prostate Cancer Prescriptions Worried or concerned Saturday 24th April 2010 about prostate cancer? 11.00 to 4.45pm National Help at the Line 0845 601 0766 Penny Brohn Cancer Centre Chapel Pill Lane PM Editor: Roger Bacon email: [email protected] Pill, Bristol You can download this newsletter direct from our website. Go to: BS20 0HH www.prostatecancerfederation.org.uk/ ProstateMatters_latest.pdf Book by phone: 01243 572990 or online The Federation e mail address is: Full programme of speakers will be sent out to member groups [email protected] and published on our website when available It is intended to publish this www.prostatecancerfederation.org.uk/agm_2010.htm newsletter 4 times a year Newsletter Sponsored by Mediwatch “Providing the complete diagnostic solution for Urologists” The Great PSA Debate – November 10th 2009, Leamington Spa Over a hundred representatives of Invited speakers that attach to its use, in particular prostate cancer patient support Before the debate proper, the scene automatic biopsy and treatment of groups went to Leamington Spa was set by Dr Dennis Brennan, a men with a PSA above a notional th on 10 November 2009 to join with recently retired company doctor, threshold.
    [Show full text]
  • A Comprehensive Review of Overactive Bladder Pathophysiology: on the Way to Tailored Treatment
    EUROPEAN UROLOGY 75 (2019) 988– 1000 available at www.sciencedirect.com journal homepage: www.europeanurology.com Review – Female Urology – Incontinence – Editor’s Choice A Comprehensive Review of Overactive Bladder Pathophysiology: On the Way to Tailored Treatment Benoit Peyronnet a,*, Emma Mironska b, Christopher Chapple b, Linda Cardozo c, Matthias Oelke d, Roger Dmochowski e,Ge´rard Amarenco f, Xavier Game´ g, Roger Kirby h, Frank Van Der Aa i, Jean-Nicolas Cornu j a Department of Urology, University Hospital of Rennes, Rennes, France; b Department of Urology, Sheffield Teaching Hospitals, Sheffield, UK; c Department of Urology, St. Antonius Hospital, Gronau, Germany; d Department of Urology, Vanderbilt University, Nashville, TN, USA; e Department of Neurourology, Tenon Hospital, Paris, France; f Department of Urogynaecology, King’s College Hospital, London, UK; g Department of Urology, University Hospital of Toulouse, Toulouse, France; h The Prostate Centre, London, UK; i Department of Urology, University of Leuven, Leuven, Belgium; j Department of Urology, University Hospital of Rouen, Rouen, France Article info Abstract Article history: Context: Current literature suggests that several pathophysiological factors and mechanisms might Accepted February 28, 2019 be responsible for the nonspecific symptom complex of overactive bladder (OAB). Objective: To provide a comprehensive analysis of the potential pathophysiology underlying Associate Editor: detrusor overactivity (DO) and OAB. Evidence acquisition: A PubMed-based literature
    [Show full text]
  • Achieving Effective Risk-Factor Modification in Men
    Risk Factor Modification v2_Layout 1 20/05/2011 15:05 Page 1 TALKING POINTS 13 Achieving effective risk-factor modification in men MICHAEL KIRBY AND ROGER KIRBY Urological complaints in men provide healthcare professionals with an opportunity to modify risk factors, thus not only averting the progression of prostate cancer and benign prostatic hyperplasia, but also reducing the hazards of cardiovascular events in men presenting with erectile dysfunction. he concept of ‘risk’ is not well will translate into Tappreciated by most men. In the premature business world, risk, when adroitly judged, morbidity and can lead to significant rewards. By mortality. contrast, most men tend to be somewhat risk averse, not only financially, but also Risk prediction more importantly in terms of approaching has become a hot their health. Attitudes between the sexes topic, not only in vary, as does their willingness to seek cardiovascular medical help and advice. Women tend to disease, but also in localised prostate Figure 1. Helping seek help earlier and are much more likely cancer, benign prostatic hyperplasia (BPH) patients counter obesity to confide in friends and relatives. and erectile dysfunction (ED), and there are by encouraging lifestyle modification major opportunities to advise corrective (patient handout available from When men eventually do present to us treatment and/or lifestyle modification www.trendsinurology.com) in the surgery or clinic, we need to take accordingly. the opportunity to think about their future risk and modify those things that PROSTATE CANCER are modifiable. A subgroup of patients presenting with localised prostate cancer can certainly be From middle age onwards we all carry stratified as high risk.
    [Show full text]
  • TUF Matters Issue 12 Read More
    ISSUE 12 TUF SPRING NEWS AND VIEWSmatters FROM THE UROLOGY FOUNDATION 2021 Bringing follow-up to the forefront Creating a lasting legacy Ending the suffering caused by urology disease theurologyfoundation.org TUFmatters ISSUE 12 | theurologyfoundation.org contents welcome to 03 Big Bake Recipe TUF matters Swap 04 Improving care and well-being across all Hello and welcome to urology TUF matters. 06 Save the Ball First I very much hope that you are keeping safe and well. We continue to live in uncertain times. When 08 Creating a lasting the pandemic first began last year we initially had legacy hopes of it being over by summer, and then by the end of the year. Now it is becoming apparent that 10 Bringing follow up Covid is something we might have to learn to live to the forefront with on an ongoing basis. Hospitals and GP practices have worked hard to make Covid-secure spaces and 12 Ticket to ride the message from urologists is clear: if you have any worries or symptoms please do not delay to seek 14 Supporting the next help or advice. Good outcomes and quality of life generation depend upon early diagnosis so don’t hesitate if you have any health concerns. 15 TUF Nuts Tuesday In the meantime, despite the stresses and strains of 2020, TUF continued to support the urology TUF Heroes 16 community and made a number of research and training awards last year, funding 10 research projects Dates for your diary 18 and supporting over 100 trainees to take part in online lectures and tutorials via the RSM.
    [Show full text]
  • Urologic Robotic Surgery in Clinical Practice Prokar Dasgupta Editor
    Urologic Robotic Surgery in Clinical Practice Prokar Dasgupta Editor Urologic Robotic Surgery in Clinical Practice Foreword by James O. Peabody and Mani Menon 123 Editor Prokar Dasgupta Department of Urology Guy’s Hospital London UK [email protected] ISBN: 978-1-84800-242-5 e-ISBN: 978-1-84800-243-2 DOI: 10.1007/978-1-84800-243-2 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Control Number: 2008936130 c Springer-Verlag London Limited 2008 Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act 1988, this publication may only be reproduced, stored or transmitted, in any form or by any means, with the prior permission in writing of the publishers, or in the case of reprographic reproduction in accordance with the terms of licenses issued by the Copyright Licensing Agency. Enquiries concerning reproduction outside those terms should be sent to the publishers. The use of registered names, trademarks, etc., in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore free for general use. The publisher makes no representation, express or implied, with regard to the accuracy of the information contained in this book and cannot accept any legal responsibility or liability for any errors or omissions that may be made. Product liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book.
    [Show full text]