With the help of our research grants, the University College Hospital Urology Team recently won an award for their pioneering improvements to prostate cancer diagnosis. We find out how two of them now hope to raise money for us on an epic cycle ride and what makes the team's work so exciting.
Two members of an award-winning research team at University College Hospital (UCH) are taking their fight against prostate cancer out of the wards and onto the roads of the Scottish Highlands, with an epic sponsored cycle ride stretching 440 miles over four days.
Dan Sinclair and Mark Cranmer are part of the UCH Urology Team, which we've awarded several research grants to in the past. The team is pioneering a world-class diagnostic service for men with suspected prostate cancer that they expect will reduce unnecessary biopsies and improve detection of aggressive cancers.
Their groundbreaking work won them a prestigious BMJ Innovation Award earlier this year, and now Dan and Mark hope to ride their team to further glories on the Scotland leg of the Deloitte Ride Across Britain, tackling more than 17,800ft of hill climbs and raising more vital funds for Prostate Cancer UK. You can help them reach their £1,000 target by sponsoring them online.
Innovation One: Team spirit
One of the most exciting things about the way this team works is that there’s a real sense of team spirit. It’s practically the dictionary definition of Men United.
They’re a mixed bag of medical staff – urologists, radiologists, pathologists, research nurses and clinical nurse specialists – combined with an academic team with expertise ranging from medical engineering to molecular biology, via health economics. Not to mention the most important team members: the men with prostate cancer.
Best of all, men are involved every step of the way, from reviewing and refining the information that’s given to patients to ethics approval and clinical trial design.
When we were working on the protocol for one particular clinical trial, one of the chaps asked us why we always asked them to be in the hospital by 9am, when their 60+ bus passes weren’t valid until 9:30. We’d never have thought of that on own.
Innovation Two: More clinical trials means more breakthroughs
The close collaboration between the academic and clinical sides of the UCH team allows them to stay at the cutting edge of prostate cancer innovation. At any one time, the team is running between ten and 15 clinical trials so every man with prostate cancer has access to at least one trial, and every man is told about all the trials he’s eligible for.
That means every patient has access to ahead-of-the-curve prostate cancer care, and everyone who takes part helps us push the limits of our knowledge to make new medical breakthroughs. You don’t get much more innovative than that.
We’re the biggest trial recruiters at UCH. Around 50% of patients on cancer trials at UCH are prostate cancer patients.
Innovation Three: MRIs that reduce and improve biopsies
The innovative approach that UCH Urology is best known for is their pioneering work on multiparametric MRI before biopsy. We’ve talked about this imaging technique before, but in a nutshell, mpMRI involves taking four different types of picture – each one looking at something slightly different, and adding another level of detail to the image of the prostate you get back at the end.
At UCH, they use this detailed information to not only make a call about whether a man really needs a biopsy at all, but also to guide the needle so they can make sure they’re taking the sample from the part of the prostate that contains the cancer. This is more accurate than the most commonly-used transrectal or TRUS biopsy, which uses ultrasound and some critics have said is like ‘going in blind’.
The team is leading a big clinical trial, called PROMIS, across a number of NHS hospitals at the moment, and it’s due to finish in October this year. This should help identify any issues around the wide-spread use of mpMRI before biopsy, including whether it still works as well outside the ‘bubble’ of UCL expertise.
Innovation Four: Making every day count
Finally (as if that’s not enough), the UCH Urology Team has really got the diagnostic process nailed. Men with a very high PSA level (just a few a week at the moment) are invited to a one-stop diagnostic shop. This means that a man will have his initial consultation and MRI on a Friday morning, the multidisciplinary team will meet at lunchtime to discuss the results and, if necessary, he’ll have his biopsy in the afternoon.
The biopsy is transperineal – through the skin rather than through the back passage – so the risk of infection is lower. The results are processed by the following Monday, he’ll be given the results on Wednesday, and discuss treatment options on Friday.
This reduces a six week process to one week. It works better for everyone. It doesn’t cost the hospital any more to speed up the process, and it’s better for patients. No-one gets stuck on a lingering pathway, and there’s less chance of missing something.
It’s another win-win innovation. Overall, it’s clear that UCH have established a world-class urology department, and are offering men an award-winning diagnostic experience.
But it can’t stop there. These developments are no good if they’re limited to North London. The doctors and scientists at UCH have set the standard, and now it’s up to us, with Men United at our side, to help them take those standards into the big wide world.
Research funding is more than important. It’s vital. Without it, we’d never be able to answer the paradigm-shifting questions. Big funders go for ‘safe’ studies, but Prostate Cancer UK funding for novel questions and novel trial designs is vital.