At Home Christian Jessen 2014 - 206

pROMOTION

MeeT THe
expeRT

Mr Hashim Uddin
Ahmed is a clinician
scientist and senior
lecturer in surgery

HiTTing
THe TaRgeT

Current diagnostics and treatments for prostate cancer cause men
more harm than good, but there are new, improved methods available

T

he way in which medical experts
diagnose and treat early prostate
cancer is not working. When
a man is suspected of having
prostate cancer, the current practice is to
take samples of tissue from the prostate
via the back passage - called transrectal
ultrasound-guided (TRUS) biopsy.

two are unable to have erections sufficient
for sexual intercourse, and one to two in 20
have back passage problems. More worryingly,
the benefit of men having radiotherapy or
surgery for improving survival is small. in
order to save the life of one man over 10
years, 12 to 48 men need to be treated.
Mr Hashim ahmed has led the change to
TRUS biopsy is a random process. This can
a better - and less harmful - pathway for men.
therefore cause obvious problems. Firstly, TRUS
a high-quality prostate magnetic resonance
biopsy can be harmful, with serious infection in two imaging (MRi) scan reported by an expert
to four in every 100 men biopsied, along with other radiologist with targeted biopsies performed
risks like blood in the urine or semen, pain and
by an expert urologist, is changing how
discomfort. Secondly, tiny areas of cells are found
medical professionals manage prostate cancer.
by chance. These look like cancer but they don't
Once an MRi is available, targeting the
grow and don't spread. However, unsurprisingly,
suspicious area accurately is crucial. although
many men have unnecessary treatment 'just in case'. this can be done through the back passage,
Thirdly, the biopsies can miss important
the risk of infection is still problematic.
cancers. Fourthly, if there is cancer, the entire
Transperineal targeted biopsies - biopsies
prostate is treated with radiotherapy or surgery.
taken through the skin - are accurate, clean
Both of these treatments cause damage to
and can be done under local anaesthetic.
surrounding structures leading to side-effects.

Managing the disease

Expert touch

Once cancer is found, most men can have
On average, around one to two in 10 men
focal therapy. This involves targeting the
become incontinent (at least one pad daily), one in tumour only, rather than targeting the whole

Mr Ahmed PhD, FRCS (Urol), BM,
BCh (Oxon), BA (Hons) (pictured,
above) is an honorary consultant
urological surgeon and an
internationally renowned expert in
prostate cancer diagnosis, imaging
and biopsy, as well as minimally
invasive therapies for prostate cancer.
He has published many of the key
papers driving the change in both the
diagnostic and treatment pathway
of prostate cancer. Mr Ahmed has
performed hundreds of transperineal
biopsies and hundreds of minimally
invasive focal therapy procedures.
He has taught dozens of surgeons
in these techniques around the world,
as well as giving lectures in this area.
He currently leads a research team with
a total grant income of over £10million.

prostate cancer in
left side confirmed
with targeted
transperineal
biopsies
R Rectum
Outlines prostate
Black area shows
treated area with
no blood supply
as a result of focal
HIFU treatment

prostate so that damage to surrounding
structures is reduced.
Focal therapy uses high-intensity focused
ultrasound or cryotherapy. in expert hands,
the risk of urinary incontinence is one to five
in 100, poor erections in one to two in 20
and rarely back passage side-effects. The
medium-term cancer control shows between
80-90% have a successful treatment. The
current pathway for prostate cancer diagnosis
and treatment is letting men down. advanced
imaging means men will have fewer, better
biopsies. it also means men will have fewer
and better treatments that cause less harm.

FOR MORE INFORMATION
Chloe Hili, Medical Secretary,
Surgical Directorate
Bupa Cromwell Hospital, 162-174
Cromwell Road, London SW5 OTU.
Call 020 7460 5911.
Fax 020 7460 5558.
Visit www.bupacromwellhospital.com/find-adoctor/find-a-consultant/hashim-ahmed/


http://www.bupacromwellhospital.com/find-a-doctor/find-a-consultant/hashim-ahmed/

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