April-May 2015 | Features

A revolution in diagnosis

A revolution in diagnosis

Why is Rotary supporting research into prostate cancer and why have they chosen to run an event to raise money and awareness? We ask one of the leading consultants in this field of work.

Rotary Clubs across Great Britain and Ireland are signing up for a big event held on Sunday June 21, 2015 that coincidentally is also Father’s Day. The event is the Rotary Ride and this year they are cycling for prostate cancer.

Prostate cancer kills 10,500 men the UK every year however it is reckoned that with proper diagnosis and treatment that number could be markedly reduced.

Why did we choose prostate cancer, I hear you ask, and why should you take part? To get answers to these questions and a few more we met up with one of the country’s leading specialists in this field. Professor Mark Emberton, of University College Hospital, leads a team working on minimally invasive methods in the diagnosis and treatment of prostatic disease with a particular emphasis on cancer.

Mark Emberton is leading the change in the way prostate cancer is diagnosed and treated and we discussed this at length. The diagnosis begins with a Prostate Specific Antigen (PSA) test, which is a very simple blood test to see if the prostate gland is working correctly. A raised PSA is merely an indication that there is the possibility of prostate cancer and not a diagnosis.  From this point further tests and diagnosis can be quite invasive and we discussed this with Mark since it is from here that his team differs from the usual continuing procedures.

Mark and his team advocate the use of Magnetic Resonant Imaging (MRI) Scans at this point. The observation was made that in many instances this would not be offered. Mark Embert on commented, “They have the means to do it since most hospitals have an MRI machine, which is busy doing hips and knees”. This was challenged and Mark went on, “Most MRI’s are reasonably full, I’m not saying MRI and the prostate is trivial, you have to do it well, machines would need  to be retuned and caring staff would need training to be able to interpret the images.

“I don’t think fund raising should pay for core NHS facilities but it could be used for training, computer aided diagnosis and implementation. All these are new skills for better diagnosis and care.”

It’s a good news story all round and we would like all men diagnosed with a high PSA to adopt the ‘Image First’ strapline.”

Mark Emberton fervently wanted to get across the message that the next stage after a PSA shows possible abnormality should be an MRI scan but it was put to him that not many NHS Trusts would take that pathway routinely. He replied, “At University College Hospital we do and everyone who has a high PSA test we do an MRI Scan and do 2,000 a year here.”

When asked if he knew of any other hospital where the scan was routine he was hard pushed to name any but did roll out the names of several in the mainland of Europe. The professor admits that he is in the early stages of a revolution in diagnosis and research in the early management of this disease. He has written many papers on the subject and was able to back his statements up with facts from papers printed all over the world.

He wants to start a lobby in the same way the lobby on breast cancer changed perceptions and treatment. He explains, “It’s a good news story all round and we would like all men diagnosed with a high PSA to adopt the ‘Image First’ strapline and lobby as this is the product of five to 10 years  of research.”

We put it to Mark that it was innovative and he agreed, “It’s what we want innovation to do, result in better health care.”

Prostate Cancer UK gave a positive but somewhat guarded response to the approach taken by Professor Emberton when asked about the advances in his work this is what Dr Iain Frame, Director of Research at Prostate Cancer UK said, “The use of MRI scans early on in the process of diagnosing prostate cancer is certainly showing promise, not only in terms of increasing the accuracy of diagnosis but also avoiding unnecessary biopsies. We will need to wait for final trial results, due later this year, before we know the full potential of this technology. In the meantime we need to see arrangements put in place to ensure that more men can benefit if the trial results are positive.”

The reasons given by Mark Emberton and the resulting changes are why we are asking everyone to participate with events held by their local Rotary Club across the country on Sunday June 21 and the initiative has the backing of the UK’s largest prostate charity, Prostate Cancer UK. Mark Bishop, Director of Fundraising at Prostate Cancer UK said: “It’s fantastic to see that Rotary has decided to organise the Rotary Ride 2015 to raise funds for Prostate Cancer UK. By doing this they, and other participating rotary clubs, are joining men united and helping to make a real difference in furthering the fight against prostate cancer.

Whatever you do together, big or small, you’ll be helping us push for real change, from more effective testing to better treatments. We thank all the rotary clubs involved and wish them every success with their challenge.”

Rotary Magazine