We have had three interesting and informative meetings over the last few months. In October, consultant clinical oncologist Dr Caroline Manetta provided an update on radical radiotherapy treatment in light of recent results from the CHHiP trial. This nine year study beginning in 2002 compared the standard 7.5 week treatment with a four week regimen. The latter was proved to be as effective. Dr Manetta explained (see slide below) what this means for men having treatment at Brighton (and in Eastbourne from 2017). HDR, which stands for ‘high dose radiotherapy’, may or may not be given to high risk patients over a two week period. Dr Manetta also discussed the side effects during and after treatment. The amount of bladder upset is about the same overall but occurred earlier in patients receiving the higher dose over a shorter period of time. Dr Manetta also provided some insight into one of the large oncology conferences held in Copenhagen which she attended earlier in the month. Run by the European Society for Medical Oncology (ESMO) the scale and scope of the conference was a surprise to the group who were shown some of the daily ‘newspapers’ that report the many concurrent events.
In November, Macmillan dietician Penny Kaye provided a comprehensive update on diet and prostate cancer. Referring to the latest evidence and in particular that provided by the World Cancer Research Fund www.wcrf.org , she spoke about a variety of aspects including the role of calcium, vitamin D and bone health, plant-based foods and body fatness. A key message was getting fitter and leaner.
Consultant urological surgeon Mr Peter Rimington gave an interesting and engaging talk in December. He firstly picked up on pre-meeting discussions about the role of exercise in recovery and in general as society ages and the burden on the NHS increases with long term conditions. He spoke about the benefits of improving physical fitness prior to surgery as well as afterwards. Then he provided an update on the work of the da Vinci robot at Eastbourne District General Hospital. The Urology Department now has a surgical fellow enabling some work around the role of simulation training for the robot, and how this is formerly recognised in certificated training. Intuitive Surgical, (http://www.intuitivesurgical.com/) the Californian manufacturer behind the da Vinci ‘minimally invasive surgical system’ has been making robots since the 1990s. Due to the microchip technology the team at Intuitive can know in real time which surgeons are using their kit and provide online advice and guidance on its maintenance, anywhere in the world. Mr Rimington spoke about the ‘immersive’ experience of using the equipment as surgeons learn how to visualise and work with it in the simulated training sessions. da Vinci Xi is now being used for colorectal surgery. At Eastbourne, having been the first hospital NHS Trust in the country to perform laparoscopic cystectomy (removal of the bladder), the robot is now being used for this too. In 2017, a new robot manufactured in Korea is to be tested in the USA.
Mr Rimington also spoke about a new surgical technique for radical prostatectomy which is claimed to reduce post operative urinary incontinence. He then concluded his talk with a reminder of the role of Active Surveillance as a treatment choice. It entails no treatment but close monitoring instead. It was initiated at the Royal Marsden Hospital seven years ago and for many men is about quality of life before other treatments may be required .
As with all our meetings there was time for questions before refreshments and the customary raffle. Please note, the Eastbourne group has no meeting in January. The next meeting is on 9 February 2017 when Mr James Moore, consultant urological surgeon will be talking about Restoring continence after Prostate Cancer surgery.