A5012237556- Prostate Cancer Diagnosis and Treatment
- Prostate Cancer Treatment and Research
- Urologic and reproductive health conditions
- Urinary Bladder and Prostate Research
- MRI in cancer diagnosis
- Bladder and Urothelial Cancer Treatments
- Genital Health and Disease
- Urological Disorders and Treatments
- Pelvic floor disorders treatments
- Reproductive tract infections research
- Economic and Financial Impacts of Cancer
- Hormonal and reproductive studies
- Ureteral procedures and complications
- Health Systems, Economic Evaluations, Quality of Life
- Urinary Tract Infections Management
- Radiomics and Machine Learning in Medical Imaging
- Herpesvirus Infections and Treatments
- Renal cell carcinoma treatment
- Colorectal Cancer Screening and Detection
- Genetic and Kidney Cyst Diseases
- Advanced Radiotherapy Techniques
- Muscle and Compartmental Disorders
- Statistical Methods in Clinical Trials
- Kidney Stones and Urolithiasis Treatments
- Renal and Vascular Pathologies
Addenbrooke's Hospital
2009-2023
University of Cambridge
1999-2017
Cambridge University Hospitals NHS Foundation Trust
2011-2016
British Association of Urological Surgeons
2016
Prostate Cancer UK
2015
Battle Hospital
1993
Churchill Hospital
1993
St. Mary’s Hospital
1988-1990
St Mary's Hospital
1989-1990
Doble (Norway)
1989
The comparative effectiveness of treatments for prostate cancer that is detected by prostate-specific antigen (PSA) testing remains uncertain.
Robust data on patient-reported outcome measures comparing treatments for clinically localized prostate cancer are lacking. We investigated the effects of active monitoring, radical prostatectomy, and radiotherapy with hormones outcomes.
Between 1999 and 2009 in the United Kingdom, 82,429 men between 50 69 years of age received a prostate-specific antigen (PSA) test. Localized prostate cancer was diagnosed 2664 men. Of these men, 1643 were enrolled trial to evaluate effectiveness treatments, with 545 randomly assigned receive active monitoring, 553 undergo prostatectomy, radiotherapy.
Objectives To improve awareness and recognition of chronic bacterial prostatitis ( CBP ) prostatitis/chronic pelvic pain syndrome (CP/CPPS) among non‐specialists patients. provide guidance to healthcare professionals treating patients with CP / CPPS , in both non‐specialist specialist settings. promote efficient referral care between specialists the involvement multidisciplinary team MDT ). Patients Methods The guideline population were men or (persistent recurrent symptoms no other...
<b>Objectives</b> To measure the effect of adverse events within 35 days transrectal ultrasound guided biopsy from perspective asymptomatic men having prostate specific antigen (PSA) testing; to assess early attitude re-biopsy; estimate healthcare resource use associated with due biopsy; and develop a classification scheme for reporting after biopsy. <b>Design</b> Prospective cohort study (Prostate Biopsy Effects: ProBE) nested Prostate Testing Cancer Treatment (ProtecT) study....
BackgroundLong-term patient-reported outcomes are needed to inform treatment decisions for localized prostate cancer.MethodsPatient-reported of 1643 randomly assigned participants in the ProtecT (Prostate Testing Cancer and Treatment) trial were evaluated assess functional quality-of-life impacts prostatectomy, radiotherapy with neoadjuvant androgen deprivation, active monitoring. This article focuses on from 7 12 years using mixed effects linear logistic models.ResultsResponse rates...
To determine the accuracy of multiparametric magnetic resonance imaging (mpMRI) during learning curve radiologists using MRI targeted, transrectal ultrasonography (TRUS) guided transperineal fusion biopsy (MTTP) for validation.Prospective data on 340 men who underwent mpMRI (T2-weighted and diffusion-weighted MRI) followed by MTTP prostate biopsy, was collected according to Ginsburg Study Group Standards Reporting Diagnostic Accuracy standards. were reported two experienced scored a Likert...
Objectives To define terms and processes agree on a minimum dataset in relation to transperineal prostate biopsy procedures enhanced diagnostics. identify the need for further evaluation establish collaborative research practice. Patients Methods A 19‐member multidisciplinary panel rated 66 items their appropriateness definition be incorporated into international databank using R esearch D evelopment/ U niversity of C alifornia L os ngeles ppropriateness M ethod. The item list was developed...
The ProtecT trial reported intention-to-treat analysis of men with localised prostate cancer (PCa) randomly allocated to active monitoring (AM), radical prostatectomy, and external beam radiotherapy. To determine report outcomes according treatment received in randomised choice cohorts. This study focuses on secondary care. Men clinically at one nine UK centres were invited participate the comparing AM, Two cohorts included 1643 who agreed be randomised; 997 declined randomisation chose...
Objectives To evaluate the influence of prostate‐specific antigen density (PSAD) on positive (PPV) and negative (NPV) predictive values multiparametric magnetic resonance imaging (mpMRI) to detect Gleason score ≥7 cancer in a repeat biopsy setting. Patients Methods Retrospective study 514 men with previous prostate showing no or 6 cancer. All had mpMRI, graded 1–5 Likert scale for suspicion, subsequent targeted 24‐core systematic image‐fusion guided transperineal 2013–2015. The NPVs PPVs...
Abstract Both multi-parametric MRI (mpMRI) and the Prostate Health Index (PHI) have shown promise in predicting a positive biopsy men with suspected prostate cancer. Here we investigated value of combining both tests requiring repeat biopsy. PHI scores were measured undergoing re-biopsy an mpMRI image-guided transperineal approach (n = 279, 94 negative mpMRIs). The was assessed for ability to add all or only significant cancers (Gleason ≥7). In this study adding improved overall cancer...
To investigate the value of second-opinion evaluation multiparametric prostate magnetic resonance imaging (MRI) by subspecialised uroradiologists at a tertiary centre for detection significant cancer in transperineal fusion biopsy. Evaluation prospectively acquired initial and radiology reports 158 patients who underwent MRI regional hospitals prior to MR/untrasound biopsy referral over 3-year period. Gleason score (GS) 7-10 cancer, positive predictive (PPV) negative (NPV) (±95 % confidence...
We studied 50 patients with chronic abacterial prostatitis as defined by the Stamey procedure via transrectal prostatic ultrasound and subsequent transperineal biopsy of abnormal areas prostate to ascertain role Chlamydia trachomatis organisms (chlamydiae) in this condition. Chlamydiae were detected an immunofluorescence technique urethra 1 patient (2 per cent) but they not recovered McCoy cell culture from tissue any nor immunofluorescence. In addition, serum antibody was found even...
Background Prostate cancer is the most common among men in UK. Prostate-specific antigen testing followed by biopsy leads to overdetection, overtreatment as well undertreatment of disease. Evidence treatment effectiveness has lacked because paucity randomised controlled trials comparing conventional treatments. Objectives To evaluate treatments for localised prostate (active monitoring, radical prostatectomy and radiotherapy) aged 50–69 years. Design A prospective, multicentre...
The aetiology of chronic prostatitis is not understood. aim this study to investigate an autoimmune hypothesis by looking for T cell proliferation in response proteins the seminal plasma. We studied peripheral blood mononuclear from 20 patients with and aged-matched controls serial dilutions plasma (SP) themselves (autologous SP) a healthy individual without disease (allo-SP). found that have statistically greater lymphocyte autologous SP at 1/50 dilution on day 6 compared (P = 0 x 01). They...
Summary— Sixty patients with chronic abacterial prostatitis and 21 men without were studied. Transperineal prosatatic biopsies taken under transrectal ultrasound control examined for antibody, complement (C 3 ) fibrinogen deposition using a direct immunofluorescence (IF) technique; 34 (57%) had tissue that displayed IF staining compared only 1 (5%) in the non‐prostatitis group. IgM was found 85%, C 44%, IgA 35% 24%, but IgG subclass not detected. Antibody mainly periglandular glandular wall...
The contribution of adrenal androgens to the maintenance and progression so-called hormone-unresponsive prostatic carcinoma was studied in 20 patients with advanced relapsed disease. role played by testicular had been negated prior orchiectomy or concurrent LHRH analogue therapy. Ketoconazole, an antifungal agent which inhibits androgenesis, administered a dose 400 mg 8-hourly, resulted optimal suppression androgens. mean serum androstenedione concentration fell from 8.01 +/- 0.84 nMol/l...
Early detection and treatment of asymptomatic men with advanced high-risk prostate cancer (PCa) may improve survival rates. To determine outcomes for diagnosed PCa following prostate-specific antigen (PSA) testing who were excluded from the ProtecT randomised trial. Mortality was compared 492 followed up a median 7.4 yr to contemporaneous cohort UK Anglia Cancer Network (ACN) matched subset ACN. PCa-specific all-cause mortality using Kaplan-Meier analysis Cox's proportional hazards...
To evaluate diffusion kurtosis imaging (DKI) and magnetisation transfer (MTI) compared to standard MRI for prostate cancer assessment in a re-biopsy population. Thirty-patients were imaged at 3 T including DKI (Kapp Dapp) with b-values 150/450/800/1150/1500 s/mm2 MTI performed without MT saturation. Patients underwent transperineal biopsy based on prospectively defined targets. Receiver-operating characteristic (ROC) analyses assessed the parameters Wilcoxon-signed ranked test relationships...
Prostate cancer in the United Kingdom is mainly diagnosed from primary care referrals based on national guidelines published by Department of Health. Here we investigated characteristics cancers detected through use these guidelines.A prospective two-centre study was established to assess men referred UK guidelines.The overall detection rate 43% (169 out 397) with 15% (26 169) all metastatic at presentation. Amongst 50-69-year-old rates were 34% (68 200) and (10 68). Only 21% (25 123) local...