Cutting-edge bespoke imaging and treatment to return patients to baseline function
Prostate Cancer: Making it Personal
Dr Shonit Punwani
Prostate cancer is the 2nd leading cause of cancer death in the UK. The prostate cancer flagship programme provides precision a cross disciplinary platform required to deliver early diagnosis, precision therapies and patient choice. As a clinician my drive is to make the fight against prostate cancer personal; to get it early; to know when and even if it needs treating; to be able to treat specifically the cancer in a way that best suits the cancer and the patient.
This Flagship Programme aims to develop new medical technologies to transform the diagnosis and management of prostate cancer. I am motivated by the promise that such technologies, and the application of engineering science, can play a critical role in better understanding the disease at all stages, predicting which men are at the greatest and lowest risk, minimising the side-effects associated with treatment, and developing new and highly effective treatments.
The Prostate Cancer Team @ University College Hospital
Having pioneered and evaluated MRI prior to prostate biopsy, the group spearheaded its dissemination across the UK to benefit the whole NHS. Current data has shown highly accurate prostate MR-imaging prior to biopsy allows men without cancer to avoid a biopsy and those with a suspicious lesion to have accurate targeted, as opposed to blind, biopsies. UCLH during this period became the first center to carry out all prostate biopsies using a transperineal (through the skin) approach and our unique pathway now includes a one-stop diagnostic service allowing men to have clinical review, MRI and transperineal targeted-biopsy all on one day. Men with a negative MRI are safely discharged without biopsy.
Our expanding focal therapy programme has seen the team evaluate several energy sources to treat Prostate Cancer including heat, cold, electricity and injectable toxcins. As with other solid organ cancers the tumour alone is targeted in order to minimise collateral damage and reduce side-effects in over 600 men so far.
The "SmartTarget" System helps Prostate Diagnosis and Biopsies
The prostate normally cannot be distinguished on ultrasound image, the standard method for guiding biopsy and a number of minimally-invasive treatments. Targeting ‘invisible’ tumours with a high degree of accuracy is extremely difficult, even for a skilled urologist. Dean Barratt (UCL CMIC) lead a Royal Academy of Engineering/EPSRC Postdoctoral Research Fellowship project to align MRI and ultrasound images, allowing information on prostate tumour location, size, and shape derived from MRI scans to be superimposed onto ultrasound scans obtained during surgical procedures, such as needle biopsy.