Meet Our Clinical Champions - Cohort 1

In April 2021, 21 Health Care Professionals from across the UK became our first cohort for the Clinical Champions Programme for Prostate Cancer.

Our Clinical Champions are leading improvement projects that aim to transform care for people living with or affected by prostate cancer over the next 18 months. You can read how they're progressing these projects twelve months into the programme and the impact they're already seeing.

Mr Alexander Rawlinson

Alex completed his fellowship training in robot assisted radical prostatectomy (RARP) in London and Merseyside. He completed his higher surgical training in Urology in the East of Scotland Deanery and was awarded the CCT in 2018.

He was appointed to lead and reorganise the prostate cancer service in NHS Fife, with the responsibility to make a positive impact on the pre and post-operative pathways for men in Fife who are choosing Robotic Assisted Radical Prostatectomy (RARP) as their treatment option. Alex also took responsibility for reorganising the Active Surveillance programme and developed a protocol in line with best evidence, working together with specialist nurse colleagues in formalising this service.

Alex's improvement project will involve making changes that will improve the diagnostic and assessment pathways with the view to increase rates of early diagnosis of prostate cancer. There are improvements to be made in current referral and diagnostic pathways which will help to ensure more patients are diagnosed early and quickly, subsequently impacting survival in the longer term.

Alex aims to establish a new diagnostic standard in line with NHS England recommendations for implementing a timed prostate cancer diagnostic pathway. The aim is for NHS Fife patients to receive a diagnosis or ruling out of prostate cancer within 14-28 days.

Mr Edward Calleja

Ed specialises in robotic pelvic Uro-Oncology at East Sussex NHS Trust. He was educated in Malta, graduating as Doctor of Medicine and Surgery in 2004 and became a urology specialist in 2014. That same year he moved to UK to further his studies in major oncology urological procedures including open and robotic pelvic surgery. He was awarded the first Henry Wade Medal in the ChM Urology by the University of Edinburgh in 2014.

He is the current lead for the non-muscle invasive bladder cancer, senior member of the multi-disciplinary team, and lead of the enhanced recovery after surgery. Education is the heart of his work. The simple act of sharing knowledge and helping other healthcare professionals move forward in their careers brings him endless satisfaction. His philosophy is ‘Ubuntu’ which means ‘I am, because you are’. 

Ed’s improvement project is part of a road map with the focus of improving the quality of health for all patients. This includes implementing a survivorship programme to address the unmet needs of prostate cancer patients through: 

• Transforming the erectile dysfunction clinic into a more holistic sexual wellbeing clinic
• Setting up a dedicated active surveillance programme
• Launching a fitness assessment clinic as part of the preoperative optimisation programme supporting patients physically and mentally prior to their surgery.

Dr Amarnath Challapalli

Amarnath specialises in the management of urological and non-melanomatous skin cancers with radiotherapy and systemic treatments. He chairs the clinical governance committee and is a member of the Medicines Advisory Group. 

He is a faculty member on courses in the Royal College of Radiologists. As a panellist on Mirrors in Medicine, an International case-based platform, he contributes on an international level to the advancement of education in prostate cancer management. As an active researcher Amarnath has been awarded a total of £2.1 million funding. He participates in clinical trials locally and nationally.

Amarnath’s improvement project is about ensuring equity of access to PSMA PET in promoting evidence based prostate cancer management. This includes detecting recurrence of prostate cancer with? Lutetium PSMA radioligand therapy when approved.

PSMA PET has a better sensitivity for detecting metastatic disease at PSA levels less than 1ng/mL. Availability of PSMA PET (not currently available widely) will improve patient selection for salvage radiotherapy, allow use of stereotactic radiotherapy for patients detected to have oligometastases and to allow patient selection for Lutetium PSMA therapy in the future.

Dr Louise Lee

Louise is a Senior Radiology Registrar at the University Hospitals of Leicester in the East Midlands deanery subspecialising in gastrointestinal and genitourinary radiology. Louise has an active interest in academia and teaching and is currently the Educational Representative for her training scheme.

As Prostate Cancer UK Clinical Champion, Louise aims to streamline the diagnostic pathway for prostate cancer services within the East Midlands region.

This will be through assessment of waiting times along the imaging and biopsy pathway whilst working closely with radiologists, urologists and cancer specialty nurses at Leicester to optimise the services and patient flow throughout the region. 

Ms Clare Waymont

Alongside her clinical commitments, Clare is President of the British Association of Urological Nurses. She leads a team of clinical nurse specialists and has developed many nurse led services including those for men with prostate cancer. Clare has a particular interest in the diagnostic pathway for prostate cancer and has expanded her practice to enable her to manage this autonomously.

She is passionate to push the boundaries of advanced practice to respond to the needs of patients and is heavily involved with the strategic development of urological services locally, regionally and nationally.

Achieving the best practice pathway for men with suspected prostate cancer is of particular focus at present. Clare and her team were the first in the West Midlands to introduce a telephone triage straight to test service for referrals of suspected prostate cancer. This was recognised nationally by winning the cancer nursing category for the 2020 Nursing Times Awards. This model of practice has been shared locally and regionally.

As part of the Clinical Champion programme, Clare is committed to introducing further improvements to the diagnostic pathway to achieve faster diagnosis of prostate cancer for patients.

Mr Samuel Worster

Sam has developed his passion for prostate cancer care whilst working as part of a multi-disciplinary team to provide a patient centred treatment pathway. 

In his role as Clinical Champion, Sam hopes to introduce a permanent prostate-rectal spacing service for prostate cancer patients undergoing radiotherapy treatments. This service aims to reduce rectal side effects and increase quality of life for a cohort of patients undergoing a long course of treatment.

The use of prostate-rectal spacers may allow for patients with pre-existing rectal conditions, who may have been unable to tolerate treatment, to be able to undergo their radiotherapy course.

Mr Nick Burns-Cox

Nick has a subspecialty interest in prostate cancer and performs robot assisted radical prostatectomy in Exeter. His specialty training was in the Wessex region and he undertook a fellowship year in Perth Australia. Nick is married and has four amazing children aged 12 to 20. He enjoys company, cycling, tennis and being busy outdoors.

Nick was an investigator for the PROMIS study. A study that demonstrated a need to change the management of men with suspected prostate cancer- introducing mpMRI into a challenging diagnostic pathway. With Southwest Cancer Alliance support, Nick and colleagues have created a database of all men entering the 2 week fast track pathway.

This database feeds into a bimonthly dashboard which displays metrics of demand, timelines and diagnostic quality. This has identified large variations in time to diagnosis but also in mpMRI quality. MRI is used to make life changing decisions therefore it needs to be done in a timely fashion, at high quality with accurate reporting if men are to benefit from this.  

While on the Clinical Champion programme, Nick aims to further improve the quality of data and the use of a dashboard in the Southwest which will be used to highlight improvements needed along the prostate cancer pathway.

Nick hopes to transform this into a national tool to ensure national quality of prostate cancer services and support operational management and planning.  

Mr Nikhil Vasdev

Nikhil’s specialist interests are Robotic Prostatectomy, Robotic Cystectomy and Intracorporeal Robotic Urinary Diversion. He is Professor of Robotic Surgery at the School of Medicine and Life Sciences at the University of Hertfordshire where he leads research groups on Biomarker development, Microfluidics liquid biopsy research and Robotic Surgery.

He was awarded a “Doctor of Science equivalent of a PhD” by the awards committee at the University of Hertfordshire in 2020 for his national and international contribution to Robotic Urological Surgery.

As Prostate Cancer UK Clinical Champion Nikhil’s improvement project will focus on Robotic Prostatectomy. The aim of the project will be to develop protocols that allow nerve sparing techniques and a reduction in the side effects whilst most importantly allowing optimisation and improvement in prostate cancer oncological control.

Dr Darren Leaning

Darren enjoys working in the North East and remains driven to help provide both the best quality care and treatment options for all patients across the region.

Currently in England, the North East and Cumbria sees the highest incidence of late stage, incurable prostate cancer at initial presentation. He therefore makes no excuses in thinking ambitiously to deliver “Project 21”. Building into work already underway at the Northern Cancer Alliance, Darren aims to:

• Expand on prostate cancer promotion and awareness with a strategic campaign.
• Explore the utility of Artificial Intelligence to improve prostate cancer pathway efficiencies in both scheduling and delivery of diagnostics.
• Build even stronger partnerships between hospital trusts, making the best use of the region’s expertise to homogenise consistent high quality patient decision making.
• Anticipate and develop the capacity across the region to accommodate exciting new evidence-based treatment paradigms with particular reference to the prostate cancer targeted radio-isotope, Lu177-PSMA617.

Through meeting like-minded colleagues and inspiring leaders both in and out of the NHS, the Prostate Cancer UK Clinical Champions programme will catalyse these goals by providing the conditions to nurture cross-pollination of ideas and enthusiasm whilst simultaneously giving the motivation to deliver improvement for patients.

Darren is thirty-nine and he is married with three children.

Mr Mark Robinson

In 2016 Mark introduced pre-biopsy mpMRI prostate and targeted biopsy to the Aneurin Bevan University Health Board. He was one of two UroRadiologists involved in the development of the 2019 Prostate Cancer NICE Guidelines Update.

He is currently working with the Welsh Assembly Government and stake holders across all Welsh Health boards, as well as primary care to facilitate the rollout of high quality mpMRI prostate pre-biopsy across Wales.

His interest in research and evidence-based changes have seen him act as Principal Investigator for multiple diagnostic and interventional radiology research studies, as well as taking a lead role overseeing local radiology research governance and assurance. His other contributions have included writing a book chapter for the World Health Organisation and collaborating to develop i-refer guidelines for the Royal College of Radiologists. He is also a Urogenital advisory editor and reviewer for Clinical Radiology.

Mark’s project includes:

• Developing a dedicated primary care referral form allowing patients to go straight to test
• Auditing mpMRI quality, to include each MRI scanner used in each Health Board
• Standardising mpMRI reporting with support for those reporting
• Standardising biopsy techniques in each Health Board and ensure access to transperineal biopsy.

Dr Oliver Hulson

Olly has a specific interest in prostate cancer diagnostics and therapy and has led the introduction of transperineal biopsy in his centre. Olly has a keen interest in teaching and education and is currently training consultant and sonographer colleagues in the new biopsy technique. 

Olly has worked closely with Prostate Cancer UK in the past on developing their patient information leaflets. This challenged his preconceptions of what constitutes good patient information. In particular, the input from patients and support groups which he found enlightening and led to him revising his own in-house information leaflets armed with this new knowledge and experience.

Olly is thrilled to be a part of Prostate Cancer UK’s Clinical Champions Programme and looks forward to meeting other like-minded individuals seeking to drive patient care forward. His project seeks to work alongside colleagues in general practice to address misconceptions regarding over-diagnosis of prostate cancer and their perceived risks of prostate biopsy.

Mr Tim Dudderidge

Tim works almost exclusively in the field of prostate cancer and is undertaking mix of prostate diagnostic work and a wide range of treatments including focal ablation with HIFU and cryotherapy and of course robotic prostatectomy.

Tim was the UK’s first robotic surgery fellow, a post supported by a Royal College of Surgeons fellowship in 2009. As well as having a high-volume clinical practice he is a Principal Investigator for prostate cancer and urinary biomarker research trials.

These trials, particularly those partnered by UCL and Imperial College have delivered game changing results and have allowed new services to become established at Southampton. Tim is a Trustee and former Board President for Doctors of the World UK, a humanitarian charity which seeks to promote free access to healthcare for all.

Tim’s vision for prostate cancer includes the reduction of harm in treating cancer, through offering active surveillance or focal therapy for suitable men. This allows them a choice between that and ‘radical’ therapies which have more side effects but possibly no oncological advantage for many men treated. Early testing with imaging rather than PSA tests may give a new momentum for screening for prostate cancer and when coupled with less risky treatments may bring the benefits without the same harms. This exciting possibility is behind his current project to deliver patient initiated testing for men in Wessex.

Mr Tom Leslie

Tom is an Honorary Senior Clinical Lecturer in Urology in the Nuffield Department of Surgical Sciences, University of Oxford. His clinical areas of interest are robotic prostatectomy, diagnosis of prostate cancer including targeted and template biopsies and minimally invasive treatments for prostate cancer.

Tom has published over 60 peer-reviewed papers, book chapters and articles. He is the Principle Investigator for NIHR funded clinical trials such as PART, TRANLSATE, PROMOTE, ADD-Aspirin, and the Medical Detection Dogs. He is LCRN Cancer Subspecialty Lead in Urology for Thames Valley and South Midlands Cancer Network and sits on the NCRI Prostate Group, the national steering group for prostate cancer research in the UK.

While on the Clinical Champions programme, Tom aims to improve the diagnostic pathway through developing a one stop MRI and local anaesthetic transperineal biopsy (LATP) service.

Tom is married with two children. Outside work, he is a mad keen sports fan and watches (or plays!) cricket, rugby and golf when family life allows.

Mr Vishwanath Hanchanale

Vish is honorary lecturer at Liverpool medical university. He has a special interest in managing prostate, bladder and testicular cancer and routinely performs robotic cancer surgery for urological cancers. Furthermore, he is actively involved in complex pelvic exenteration and retroperitoneal lymph node dissections.

Vish is an executive member of the National BAUS section of Oncology and Surgical Specialty Board (Urology) at RCS Edinburgh. Recognising his medical education and simulation interests, he was recently appointed as the course director for the National “ST3 Urology Simulation Bootcamp” at Leeds. With his active involvement in research and service improvement projects, he has managed to publish and present in international journals and urology conferences.

As a passionate advocate of prostate cancer diagnostics, Vish was the key member in setting up a prostate cancer diagnostic pathway including local anaesthetic transperineal prostate (LATP) biopsies at Royal Liverpool Hospital.

Vish is thrilled to be part of the Prostate Cancer UK Clinical Champions programme and aspires to streamline the prostate cancer diagnostic services across the area to improve each patient’s journey.

Mr William Cross

Bill’s research interests span from prostate cancer diagnostics to the management of advanced disease. Bill is passionate that all patients should have access to the latest treatment options and the opportunity to be involved in clinical studies.

Bill is a member of the trial management group of the internationally recognised RADICALS and STAMPEDE trials, which have contributed to advancing clinical practice globally. Appreciating the importance of education and training, Bill continues to work with Prostate Cancer UK to deliver masterclasses and develop information resources and guidelines.

Through the Clinical Champions programme Bill aims to improve the delivery of care and the patient experience for men with advanced prostate cancer. Bill and his team plan to develop an IT system which will assist and guide healthcare teams to provide the latest therapies and record real-world clinical outcomes which will inform future services improvements. This ambitious project is focused on providing patients with a personalised treatment pathway with access to the latest information, support and guidance.

Dr Stephen Mangar

Steve is passionate and committed to integrating high quality research into the clinical arena for the benefit of his patients. He has participated in various National Cancer Research Network trials which have changed clinical practice such as RT01, CHHiP, STAMPEDE and PATCH, in addition to commercially funded projects and collaboration with international colleagues. He is a member of Comprehensive Cancer Imaging at Imperial College and has been the Chief Investigator for studies looking at novel radionuclide tracers for imaging prostate cancer.

His current interests involve improving prostate radiotherapy outcomes, exploring extreme hypofractionation in prostate cancer using Stereotactic Ablative Radiotherapy (SABR). He recently completed recruitment for his own investigator led trial looking at wrist actigraphy for objective assessment of sleep patterns in patients receiving hormonal therapy for prostate cancer.

With the support of Prostate Cancer UK as a Clinical Champion, Steve hopes to develop three projects:

• Protocols and training in order to implement SABR into routine clinical practice for both radical and palliative treatment.
• To develop functional imaging for prostate cancer staging, so that it becomes more readily available for staging high risk prostate cancer.
• To use actigraphy to help understand the impact various treatments have on sleep quality.

Steve hopes that these measures will make a significant impact in treatment delivery and improving the quality of life for prostate cancer patients.

Dr Iztok Caglic

Iztok completed his radiology training in Slovenia in 2016, before embarking on a 1-year body cross-sectional fellowship at Addenbrooke's Hospital focusing on uro-radiology, under the tutelage of Dr Tristan Barrett. Prostate imaging became a keen interest early in his career which led him to undertake his doctoral PhD thesis entitled "The role of modern magnetic resonance techniques and patient preparation in evaluation of prostate cancer".

His research interests lie in prostate cancer imaging, particularly in the use of mpMRI for detection and local staging of prostate cancer and in active surveillance. He has been involved in developing and helping to run an mpMRI prostate regional training scheme in collaboration with Prostate Cancer UK and has been an invited lecturer on Cambridge Prostate mpMRI Course since 2017. He is a member of the European Society of Radiology and the British Society of Urogenital Radiology.

As part of the Clinical Champions Programme, Iztok will lead on a project which aims to offer men presenting with suspected prostate cancer a novel one stop comprehensive imaging appointment. This would combine the existing, established prebiopsy mpMRI test with "next-generation" imaging, namely whole-body MRI (WB-MRI).

The proposed pathway will be based on PSA-stratification and pre-booked MRI slots which would vary in length, tailored to each individual patients’ needs, thereby improving the patient experience and facilitating diagnostic-workup to meet the national 28-day cancer pathway.

Dr Fabio Castiglione

Fabio is a Urologist and Andrologist in London. He currently works as Lecturer at UCLH and as Senior Clinical Fellow at the department of Andrology at UCLH. 

He earned his PhD on regenerative medicine for erectile dysfunction at the Katholieke Universiteit Leuven in Belgium. He is a fellow of the European Committee of Sexual Medicine, the European Urology Board and member of the scientific committee of the Andrological Guidelines of the International Sexual Medicine Society, European Society of Urology and of the European Society for Sexual Medicine.

Fabio is extremely knowledgeable about erectile dysfunction and penile rehabilitation after prostate cancer treatment and is author of more than 70 peer reviewed publications.

Fabio aims to develop new clinical pathways and deliver significant improvements to patients suffering from erectile dysfunction and sexual dysfunction following prostate cancer treatments.  This will make a meaningful difference for these patients locally but could also aid in the development of national guidelines which can be used in other regions.

Professor Janet Brown

Janet has more than 20 years’ experience working on the effects of cancer- including prostate cancer on bones. Amongst a range of awards, Janet gained the American Society for Clinical Oncology Pain Merit Award in 2003 and a Cancer Research UK Clinician Scientist Fellowship for studies in bone oncology in 2008. She has published approximately 150 peer-reviewed research papers, many in prostate cancer.

Janet leads the Clinical Bone Oncology and Biomarkers Group in University of Sheffield, which has a particular focus on the impact of cancer (including prostate cancer) on the skeleton and is a member of the Advanced Prostate Cancer sub-group of the UK NCRI Prostate Cancer Clinical Studies Group.

Around one third of patients with prostate cancer will receive androgen deprivation therapy (ADT) which substantially improves survival. However, ADT causes significant loss of bone mineral density. This cancer treatment induced bone loss may lead to osteoporosis and subsequent fractures. The management of this risk is currently sub-optimal and improving assessment of the risk of osteoporotic fracture will help put in place measures to prevent it.

For several years, Janet has led the UK Prostate Cancer Bone Health Guidelines Group, which published a new set of guidelines for optimising bone health in prostate cancer in 2020.

Her Clinical Champions project will focus on using these guidelines to optimise bone health of prostate cancer patients regionally, with the intention to roll this out nationally as a significant service improvement to enhance quality of life in patients with prostate cancer.

Mr Will Kinnaird

Will is in a urology research and development role looking at ways to improve care for men with prostate cancer. His work involves setting up and helping to run trials and audits as well as developing services and supporting with the clinical side of prostate cancer treatment.

Will has spent a large portion of his career delivering external beam radiotherapy, so came into this research role from a treatment floor background. His current role incorporates both clinical and research aspects, which allows him to make the connection between the treatments delivered and long-term consequences.

Sexual dysfunction is one of the most common side effects of nearly all prostate cancer treatments. Men experience erectile dysfunction, penis shrinkage, ejaculatory disorders, orgasmic changes and urinary incontinence during sexual activity. Surveys of men with prostate cancer show they do not receive the help they need to deal with these issues.

This issue is particularly bad for men with advanced disease, who are living longer than ever, but often face the consequences of life-long hormone treatment. This project aims to draw up national guidance for managing sexual dysfunction in men with advanced disease.

This will involve gathering the views of patients and health care professionals, as well as assessing the current evidence to identify the very best treatments for these men. The aim is to provide a template for healthcare professionals and patients to help address this growing need.