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Prostate Cancer Diagnosis

For more information on Precision Prostate Diagnostics at

London Bridge Hospital, please contact the GP Liaison Team on:

T: 020 7234 2009

London Spinal Centre

FOURTEEN

Prostate Cancer Diagnosis

F RTEE

Changing the

Path of Prostate

Cancer Diagnosis

More than 100 men are diagnosed with

prostate cancer every day. By 2030, it is

expected to be the most common cancer

– affecting one in eight men, with over

a quarter of a million more either living

with it, or having recovered.

London Bridge Hospital is continuing

our dedication to providing the highest

standards of medical excellence with

the introduction of Precision Prostate

Diagnostics. The team of Consultants

and Clinical Nurse Specialists at London

Bridge Urology are using this latest

diagnostic technique to determine the

individual risk within each patient; resolving

uncertainty by specifically identifying

whether or not a biopsy is required.

For the last 25 years, the typical pathway

for prostate cancer diagnosis has remained

unchanged. Mr Rick Popert, Consultant

Urological Surgeon, says,“The standard

pathway risks both under-diagnosis and

misdiagnosis, potentially leading to either

over-treatment (unnecessary radical

surgery) or under-treatment (from false

reassurance).”

London Bridge Hospital’s Precision

Prostate Diagnostics assessment is an

entirely new approach to diagnosis.

As before, patients with an elevated

PSA should be referred, where they

will undergo a comprehensive prostate

assessment, an evaluation of their urinary

system, a diagnostic 3Tesla (3T) MRI

scan and complete a prostate health

questionnaire, to assess the prostate more

accurately before any decision is made

about the need for a biopsy. London

Bridge Hospital was the first within the

HCA group to acquire a 3T scanner,

allowing for improved prostate diagnosis.

London Bridge Hospital’s unrivalled

access to state-of-the-art imaging allows

the MRI scan result to be delivered during

the patient’s initial consultation with

a Consultant; putting them in a better

position to decide whether a prostate

biopsy is required, and if so, the best

method with which to carry out a

precision-targeted biopsy. Although an

MRI may identify a small lesion within

the prostate that cannot be seen on

an ultrasound, with modern computer

software, static images of the MRI with

the lesion identified can be ‘fused’ with

the live ultrasound, to provide precision-

targeted biopsies of the prostate. This

has improved cancer diagnosis rates from

around 40% of cases to 65% of cases.

This information allows the team at

London Bridge Hospital to select patients

for active surveillance safely, and provide

targeted, focused treatments, such as

brachytherapy, or nerve sparing robotic

surgery in more aggressive cases.

“Precision Prostate Diagnostics provides

better individualised assessment and

treatment for prostate cancer,” says

Mr Popert.“The improved image quality

and ability to ‘fuse’ the 3T MRI images

with live ultrasound provides the most

precise method to target specific areas

within the prostate. Unlike the traditional

pathway, Precision Prostate Diagnostics

shows us the exact location of any

suspicious lesions within the prostate,

before we do a biopsy.”

He continues,“It means we can better-

target the abnormality, minimising

unnecessary biopsies of normal prostate

tissue, and optimising the sampling

of the abnormal or suspicious

prostate. If a prostate biopsy

is needed, ideally, it should

be done once and once

only. This technology

helps us to resolve the

uncertainty of PSA

testing, providing

reassurance to

many and accurate

diagnosis and

treatment to

those at risk from

prostate cancer

progression.”

London Bridge Hospital

Mr Rick Popert

MS FRCS (Urol)

Consultant Urologist

Mr Popert was appointed as

a Consultant in 1996, having

completed his higher surgical

training at Guy’s Hospital and

urological research at King’s

College Hospital.

Alongside his special interest in

Precision Prostate Diagnostics,

Mr Popert’s surgical expertise

spans into radical prostatectomy.

He has the UK’s largest

experience of single visit

dynamic intra-operative prostate

brachytherapy and has carried

out over 600 of these cases

between 2004 and 2012.

For benign prostatic disease,

he has introduced a holmium

laser prostatectomy (HoLEP)

service at Guy’s and London

Bridge Hospitals. He has

carried out over 500 holmium

laser enucleations with reduced

bleeding and length of stay in

patients with prostate volumes

larger than 100cc compared

with standard Trans-Urethral

Prostatectomy (TURP).