Wonder Gel...

Wonder gel protects prostate patients from collateral damage

A GEL that prevents damage from radiotherapy could help thousands of men treated for prostate cancer by separating the prostate gland from the rectum. 

By PAT HAGAN

PUBLISHED: 13:45, Tue, Sep 29, 2015 | UPDATED: 13:54, Tue, Sep 29, 2015

6

Digsby

IM, Email, and Social Networks in one easy to use application!

http://kvors.com/click/?s=88377&c=89569&subid=21512

ALAMY
A new gel can help reduce the damage caused by radiotherapy

If radiotherapy treatment is needed to zap cancerous cells in the prostate there is a high chance of "collateral" damage to healthy tissue in the surrounding area.

Yet a high-tech gel already being used by specialists at The London Clinic could eventually benefit thousands more men who undergo the treatment every year in the UK.

Radiotherapy is the most common form of treatment for prostate cancer, firing high-energy X-rays into the damaged area to destroy any cancerous cells.

Although it is painless, it does mean attending hospital five days a week for several weeks to have a daily blast of treatment that takes between 10 and 20 minutes.

However it can be extremely difficult to precisely pinpoint the right target zone. As a result, a significant number of men end up with radiation damage to the rectal wall which can cause diarrhoea, rectal bleeding and painful tissue "tears" called fistulas. The condition is so common it even has its own name, radiation proctitis.

Many patients experience rectal bleeding within six weeks or so of starting radiotherapy but it can develop up to nine months after treatment has ended.

Many patients experience rectal bleeding within six weeks or so of starting radiotherapy 

The revolutionary new substance, called SpaceOAR gel, gets round the problem with a brilliantly simple solution.

It is injected into the area in liquid form once the patient has had either a general or local anaesthetic or has been sedated.

It contains water and two liquids which, when combined, quickly turn into a soft gel that sets and remains in place.

This same material is already deployed in other areas of medicine, including surgical sealants used in the brain and spine.

SECONDS after being injected, the liquid solidifies and expands to push the rectum several inches away from the prostate.

Doctors can then target the prostate, safe in the knowledge that they will not damage the rectal wall.

US firm Augmenix Inc, which makes the gel, says it is possible that doctors could increase the amount of radiotherapy because the risk of collateral damage is reduced and that high-dose radiotherapy could improve a patient's chances of making a full recovery.

Once the treatment is finished the gel stays in place for about six months, which is long enough to cover repeat courses of radiotherapy.

After that it gradually breaks down and gets harmlessly absorbed by the body, with little or no discomfort to the patient.

Every year in the UK nearly 40,000 cases of prostate cancer are diagnosed and it kills 10,000 men, equivalent to more than one an hour. The risks increase with age, men over 50 are more likely to develop a tumour and there is a strong genetic element to it.

"Some men develop ulcers or bleeding from radiation proctitis and it can be very troublesome. We are getting better at focusing radiotherapy beams more precisely but as the rectum is millimetres away it often gets caught up in it.

"Yet if you can just move it away from the prostate by even a couple of centimetres it can really help. That means you can give a higher dose and target it more precisely.

"This gel is still largely experimental but it's a fairly obvious solution to a common problem and is highly likely to be very effective. It is potentially quite a big breakthrough."

Small town to big city? Penrith v Bangkok...

Moving from 'small town' Penrith to 'mega city' Bangkok has been a mental journey that I would find hard to describe. However, I found this blog by a guy, Austin Evans, from a 'small town' in the USA called St. Joe. He does business in Las Vegas and gives a great account of his thinking as he jumps between the two.

I've substituted 'St Joe' with 'Penrith', and 'Vegas' with 'Bangkok' just for fun, and I think it works. Do you?

"I was out in Bangkok for a Snap Fitness Convention this past week and today when I got home I was thinking of something I always catch myself thinking about when I get back from big cities: Just be yourself. 

What do I mean though?

When you’re in a big city, you see every walk of life there is: bums digging in trash cans, 3 foot tall spray-painted Mohawks, girls running around with tassels hanging off of their nipples, businessmen walking in suits, every kind you can picture. (I’m a pro at people watching and thoroughly enjoy it).

In my hometown of Penrith, there are about 80,000 people and if you can make sense of this, it’s the biggest small town ever. What I mean by that is that everyone knows what everyone’s doing, anything remotely ‘private’ about someone is revealed to everybody and the talk of the town. In Penrith, if you’re walking through the co-op near a stranger & you’re on the phone, most of the time you’ll say “hold on” or you’ll stall your conversation until you’re away from them, I guess just thinking that people are listening? In Penrith when you want to wear an outfit and you think the shirt you have on is cool because it’s different and nobody else will have it, most will not wear it because it is different and they care what people are going to think and say about it, they don’t want to be ‘weird’. In Penrith if you want to start a business or a blog, whatever it is, there are so many naysayers there to shoot you down. And instead of just doing what they want, and going after their goals, people think of how everyone will respond: Oh my god what will so and so think?

But in Bangkok and every big city I’ve been to, people just straight up don’t give a damn what people think. 

They don’t care about your opinion of how they look, what they’re doing, what they’re saying, anything! Whether you like what they’re doing or not, they’re going to keep doing it…’right’ or ‘wrong’.

Also, in comparing big cities to Penrith (and many other small towns), you know what else I’ve noticed? Money. Everywhere you go is high-end architecture, Rolls-Royces, luxury stores (that are being supported whether it’s by tourists or not). And I think that goes hand in hand with people simply not caring what people think. They don’t listen to naysayers because they know what they’re capable of. In Penrith though, people settle & people stress over what people think.

I always come back from trips super motivated by all the success and opportunity in the air that I was surrounded by in the big cities. Then I arrive in Penrith and have the same realization every time: how much people care what others think, and how I still catch myself somewhat caring a little bit of what people think sometimes & I hate it. I’m done with it.

Out there, no one cares if you become a billionaire CEO or if you’re a bum on the street. People don’t turn their head for a double take, or even look at you the first time, if you walk down the strip in a speedo with a horse mask [I’ve never tried but I’m sure they wouldn’t]. And it’s not just because they don’t know you, it’s because they’re worried about their own life. Some of them may be self-centered but I feel, as though most are just so focused on what they have going on, that you can’t faze them.

I’m not saying to become a selfish douchebag; but start worrying about your own life and where you are headed, and stop caring what anyone else thinks. The truth is, whether you succeed at what you attempt or not, there are still going to be people talking shit about you. So have extremely thick skin and you do you, nobody else.

Look at the most successful people in the world and you’ll see that thick skin is a quality they all carry. I can guarantee that not caring what anyone thinks will be one of the best choices you ever make."

Some people spend their lives, 'sweating the small stuff', because they have never been handed the 'BIG stuff'.

Rod Coverley describes how it was for him, in the '24 hours' after he was diagnosed with Prostate Cancer.

It's a shame that this '24 hours' can't be put in a box and given to everyone. 
Unless you have been there, you can't begin to contemplate it.
It changes your perspective on everything, and makes you realise that some things you once saw as problems, are now just laughable. 
Some people spend their lives, 'sweating the small stuff', because they have never been handed the 'BIG stuff'.

Listen to Rod's story...

"You have prostate cancer" – four words that will change your life. Many men tell us about the shock, numbness, and disbelief after being given their diagnosis. Rod Coverley, 60, originally from South Africa and now living in Dorset, heard these words in July 2014. He tells us of the suicidal thoughts that went through his mind immediately afterwards, and how our booklet helped him to see light at the end of the tunnel.

When I was told I had prostate cancer, I was dumbfounded. It didn’t sink in. Up to that point there’d been no mention of prostate cancer. I didn’t think it could happen to me.

I’d noticed I’d had peeing problems for a while. I remember going to a restaurant with friends, visiting the toilet and just splashing. It was embarrassing. I had an MRI and a biopsy, and then I got a letter to see my consultant.

I’d gone to the appointment on my own. My wife had said, "Do you want me to come with you?’ and I said, "No, nothing will happen, it’s just a formality. I’ll come home and cook dinner. You go out and meet your friend."

When the consultant broke the news my world fell apart.

The longest journey home

The first thing I asked was, "What are my options?" I wanted it out; it’s my body. But because of my emphysema, I was told they couldn’t. The nurse gave me a Prostate Cancer UK booklet and off I went.

I had to catch two buses home. It seemed like it was the longest journey I have ever had to take. I was alone and terrified. My father had died from prostate cancer in 1997 aged 69 and his two brothers had died from it too, one as recent as this year. So I wasn’t giving myself much chance.

There was just so much going on in my mind. What was I going to tell my wife, Sandy, and the rest of my family? What about the granddaughter I haven’t even met yet? My mother is not too well herself and I had my three daughters to tell, with one of them in rehab for taking drugs (I had just been through the trauma of saving her life). I just felt useless. The whole way home I thought about the tablets I had at home for getting to sleep at night. I reckoned I had about 250. I thought, if three can put me to sleep what can 250 do? I was seriously thinking about it.

I’d never thought about committing suicide. I was a confident, strong, successful person.

I got home, opened a can of beer and found the tablets. I was going to take them but my wife’s face kept flashing in my mind. She didn’t know anything. Do I do it or do I not? It was the strangest feeling. I’d never thought about committing suicide. I was a confident, strong, successful person. I’d had a great career as a chef, both here and in South Africa. But I felt like I couldn’t do anything, like someone was taking my life away from me.

Relief to discover I was not alone

I put the tablets by the beer and decided to read the booklet the nurse gave me. I saw the Prostate Cancer UK website on the back and I went there and started reading. As I read through all the information, the thoughts of me taking my own life went away because I found I was not alone. I had options for my treatment and a support group waiting for my call. It was just a great relief.

I didn’t want to be a burden on Sandy. But now I knew she would have support if she wanted it too. So I waited for her to get home to see how we could get through it.
When she did, I just blurted it out and we stood there hugging for I don’t know how long. We didn’t say anything, absolutely nothing. We hugged and we cried.

When I went to bed I still felt so scared – those thoughts just don’t go away. I carried on reading the booklet and going on the website and felt more confident about what was going on. Now I knew there was someone there that I could speak to: Prostate Cancer UK’s Specialist Nurses. When I phoned the hospital I knew what to ask and knew about my rights. Before this, I barely even knew what a prostate was.

I also learnt about the increased risk because of family history; before I just put it down to coincidence. My mother also had both of her breasts removed, my father’s sister died of breast cancer and my mother’s sister had a double mastectomy, too. So there’s a history of cancer on both sides.

Armed with information for treatment

Once I was armed with information, I pushed for surgery and I eventually had my prostate removed in January 2015. Now I’ve got my whole life back and my latest PSA came back as 0.01. OK, I’ve got incontinence, which I battle with, and I can’t get an erection (my penis has decided to hide away!). But as I said to my wife at the time, if you want to have children now you’ll have to adopt! At 65, she turned to me and laughed.

It was a long and hard road and those negative thoughts stayed with me for a long time. But I still have my life and my wife. I’m active and I’m fine.

If I didn’t have that booklet or know there was a Specialist Nurse at the end of the line, I dread to think what would have happened that first day.

I’m telling you all this because I want to be as honest as possible – there’s no point hiding facts. I want to be full on because I think it's important people are made aware of what it’s like.

When I look back on the first 24 hours, I do feel really silly but it was important. It was a life-changing day. Maybe I became humble? Before then, I didn’t notice other people’s problems as much as I should have. I was confident it was never going to happen to me. But I guess we all think that.

That’s why I decided to volunteer for Prostate Cancer UK. Prostate Cancer UK saved my life so I want to help others, like me, who think it won’t ever happen to them. If I didn’t have that booklet or know there was a Specialist Nurse at the end of the line, I dread to think what would have happened that first day.  

All I can do is raise awareness, share my story and tell people to get in touch with Prostate Cancer UK or go to their doctor. And I know a few people have because my doctor told me at our last appointment! It makes me feel good when I help other people. And if my story can help make people aware, it would make me the happiest man in the world.

What's gone wrong at Addenbrookes?

Addenbrooke's and Rosie Hospitals placed in special measures

• 6 hours ago
 
• From the section Cambridgeshire

Image copyrightPA

Image captionCambridge University Hospitals controls the Addenbrooke's and Rosie facilities in the city

One of the biggest NHS trusts has been placed in special measures after inspectors found it was "inadequate".

NHS regulator Monitor is taking action to improve Cambridge University Hospitals Trust, which runs the city's Addenbrooke's and Rosie Birth Centre.

Inspectors found concerns about staffing levels, delays in outpatient treatment and governance failings.

The trust, which Monitor said was predicting a £64m deficit this year, has apologised to patients.

Monitor said the trust had an average overspend of £1.2m a week.

The trust's chief executive, Keith McNeil, stepped down suddenly last week, citing "a number of very serious challenges".

Chief finance officer Paul James also quit ahead of the CQC's report.

'Rapid action'

The Care Quality Commission (CQC) found staff shortages and long-standing "serious" problems had been ignored. 

The watchdog's report said the trust must develop and implement a recovery plan to address its financial deficit and strengthen leadership by working with an "improvement director" appointed by Monitor.

The trust's chairwoman Jane Ramsey said: "I would like to say sorry to our patients for a lack of effective systems and processes across our trust, which led to the CQC rating our hospitals as inadequate.

"We take this, and being placed in special measures by our regulator Monitor, very seriously.

"We will take rapid action to address concerns and maintain our record of safety and high-quality care."

Monitor has also imposed a new condition on the trust's licence, enabling the regulator to take further action, such as replacing senior staff, if improvements are not made swiftly enough.

Analysis 

By Nick Triggle, Health Correspondent

Perhaps the most worrying aspect of the Addenbrooke's story is not that such a world-renowned hospital has ended up in a predicament like this, but rather that it happened so quickly.

A year ago the trust which runs the hospital - Cambridge University Hospitals NHS Foundation Trust - wasn't even on the Care Quality Commission's radar in terms of being a failing centre. 

In fact, two years ago - as the regulator was embarking on its new inspection regime - it was among the band of hospitals considered to be the safest, according to the risk-rating system at the time.

But now a hospital which can boast to being a centre of excellence for major trauma, transplants, cancer, neurosurgery, genetics and paediatrics, has been judged to be a basket case and will join the 12 other failing hospitals already placed in special measures.

So what does this tell us about the state of health of the NHS? Sir Mike Richards, the CQC's chief inspector of hospitals, believes Addenbrooke's problems are largely of its own making, criticising the trust's management for "losing grip". 

Certainly it seems to have made mistakes - as the troubles with its £200m computerised patient records programme illustrates - but it's hard to escape the feeling that this is just the tip of the iceberg.

Read Nick's blog in full

The CQC also found routine operations were frequently cancelled and maternity services regularly closed.

It said high levels of nitrous oxide, used as pain relief in childbirth, were detected at Rosie Hospital's birthing centre, but the only action taken to address it was to open windows.

It also said workers were prepared to go the extra mile for patients, rating the quality of care as "outstanding".

Image captionDr Keith McNeil left the trust last week, citing "serious challenges"

Stephen Hay, Monitor's managing director of provider regulation, said: "Patients treated at Cambridge University Hospitals NHS Foundation Trust deserve to receive the highest possible care, and so the failings that we and the CQC have identified in the trust's services are disappointing.

"It's reassuring that the trust has already started to address some of the issues, but much more needs to be done.

"Special measures will ensure it gets the extra help and support it needs."

Monthly publication by Prostate Cancer UK

Dear Daniel In your September Insights, we call on hospitals to end the patient lottery for access to new treatments, hear the moving personal stories of those organising a Lads Night In (including Robbie Savage), and meet the five brilliant new PhD students we're funding to continue our cutting edge lab research. We've also got all the latest on how the Government's new cancer targets and the dropping of radium-223on the NHS impacts men with prostate cancer. And we talk to two extraordinary survivors: one about his record-breaking trek to the South Pole, the other his brave recollection of the suicidal thoughts he battled in the 24 hours following his diagnosis. The 'golden opportunity' to speed up access to new treatments After the Government’s Accelerated Access Review this week, we look at how the STAMPEDE trial could help herald the speedier adoption of new treatments by hospitals, and hear of the terrible human costs of delays in making early chemotherapy available to men with advanced prostate cancer. Playing for the highest of stakes More than 9,000 people are expected to be dealing their cards and donating their winnings as part of our Lads Night In poker fundraiser on 25 September. While it's all about having fun with your mates, for three game organisers – including former footballer Robbie Savage – there are more serious reasons for playing. Meet our new PhD researchers After another obscenely expensive football transfer window closes, we showcase the five new PhD students we've signed to Men United for just £500k, who will help continue our vital research into prostate cancer in labs across the UK. Useful links Need more info? Order free publications. Diagnosed or concerned about prostate cancer? Speak to our specialist nurses. Find support in your area.