Caroline M. Moore | |
---|---|
Occupation | Urologist |
Academic background | |
Education | St George's, University of London |
Thesis | "Photodynamic therapy for Prostate Cancer" (2007) |
Academic work | |
Institutions | University College London University College London Hospital |
Caroline M. Moore is the first woman to be made a professor of urology in the United Kingdom. She works in the diagnosis and treatment of prostate cancer at University College London.
Her research on evaluating photodynamic therapy for prostate cancer,became the subject of her MD,which was completed in 2007,and led to the first completed randomised trial comparing focal treatment for prostate cancer with active surveillance.
Caroline Moore was born in Chester,and moved to Wombourne at the age of five. She was educated at St. Edmunds Catholic College before gaining admission to study medicine at St George's Hospital Medical School,London,from where she graduated in 1997. [1]
After completing her early medical training in London,she gained membership of the Royal College of Surgeons,who subsequently awarded her a research fellowship. Her research began in 2002 on evaluating photodynamic therapy for prostate cancer. It became the subject of her MD,which was completed in 2007,and led to the first completed randomised trial comparing focal treatment for prostate cancer with active surveillance. Later,she published the first study using magnetic resonance imaging (MRI) to evaluate treatment in early prostate cancer. [1] [2] [3]
Moore started using MRI to detect prostate cancer in men who would not need treatment,and found that if biopsies were performed before MRI scans the images were blurred. [4]
In October 2012 she established a committee on Standards in Reporting in MRI-targeted biopsy (START). [5] [ citation needed ] The recommendations included reporting histologic results of standard cores using Gleason scores and maximum core cancer length,as well as reporting the recruitment criteria,radiologist experience and population biopsy status of a particular trial. [5] [ citation needed ] She has worked on a combination of multi-parametric MRI and cognitive fusion transperineal biopsy,which can reduce the time taken diagnose and treat diseases. [6] [ citation needed ] She has found that using MRI can reduce the need for biopsies by 28%. [7] [8] [9] In 2019,her MRI protocols were approved by the National Institute for Health and Care Excellence (NICE),and incorporated into national guidance for the investigation of men suspected of having clinically localised prostate cancer. [10]
Moore has developed electronic psychometric patient-reported outcome measures to monitor men who have had radical prostatectomy. [11] Men who have this surgery can suffer from urinary leakage and difficulties with erections. The survey allows researchers to track their progress and share information with their surgical teams. [12] Moore has been among a group of researchers spread across six hospitals who have been investigating high-intensity focused ultrasound (HIFU) as a treatment for prostate cancer. Five years after treatment with HIFU the cancer survival rate is 100%,the same as for the more traditional methods of surgery and radiotherapy,but with fewer side-effects. [13]
She has been Head of Urology at University College London,within the Division of Surgical and Interventional Sciences since 2018. She was senior author on the Prostate Evaluation for Clinically Important Disease:Sampling Using Image Guidance or Not? (PRECISION) study comparing standard prostate biopsy and MRI-targeted biopsy. [11] [14] [15] [16]
In 2019 Moore was the first woman in the United Kingdom to be made a Professor of Urology. [1] Her research has been supported by Prostate Cancer UK,the Movember Foundation,the Cancer Vaccine Institute,the National Institute for Health Research,the European Association of Urology Research Foundation,the Wellcome Trust and the Department of Health. [2] [17]
She serves on the board of the European Association of Urology Research Foundation. [18]
She has served as a science consultant for the science comic Surgeon X. [19]
Moore was part of the team that was awarded The BMJ "UK Research Paper" of the year. [20]
Moore has four children. [1]
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: CS1 maint: date and year (link) (Joint author)Prostate cancer is the uncontrolled growth of cells in the prostate, a gland in the male reproductive system below the bladder. Abnormal growth of prostate tissue is usually detected through screening tests, typically blood tests that check for prostate-specific antigen (PSA) levels. Those with high levels of PSA in their blood are at increased risk for developing prostate cancer. Diagnosis requires a biopsy of the prostate. If cancer is present, the pathologist assigns a Gleason score, and a higher score represents a more dangerous tumor. Medical imaging is performed to look for cancer that has spread outside the prostate. Based on the Gleason score, PSA levels, and imaging results, a cancer case is assigned a stage 1 to 4. A higher stage signifies a more advanced, more dangerous disease.
Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss of bladder control. Complications can include urinary tract infections, bladder stones, and chronic kidney problems.
Bladder cancer is any of several types of cancer arising from the tissues of the urinary bladder. Symptoms include blood in the urine, pain with urination, and low back pain. It is caused when epithelial cells that line the bladder become malignant.
Prostate-specific antigen (PSA), also known as gamma-seminoprotein or kallikrein-3 (KLK3), P-30 antigen, is a glycoprotein enzyme encoded in humans by the KLK3 gene. PSA is a member of the kallikrein-related peptidase family and is secreted by the epithelial cells of the prostate gland in men and the paraurethral glands in women.
Glomerulation refers to bladder hemorrhages which are thought to be associated with some types of interstitial cystitis (IC).
Prostate biopsy is a procedure in which small hollow needle-core samples are removed from a man's prostate gland to be examined for the presence of prostate cancer. It is typically performed when the result from a PSA blood test is high. It may also be considered advisable after a digital rectal exam (DRE) finds possible abnormality. PSA screening is controversial as PSA may become elevated due to non-cancerous conditions such as benign prostatic hyperplasia (BPH), by infection, or by manipulation of the prostate during surgery or catheterization. Additionally many prostate cancers detected by screening develop so slowly that they would not cause problems during a man's lifetime, making the complications due to treatment unnecessary.
The sentinel lymph node is the hypothetical first lymph node or group of nodes draining a cancer. In case of established cancerous dissemination it is postulated that the sentinel lymph nodes are the target organs primarily reached by metastasizing cancer cells from the tumor.
Prostate cancer staging is the process by which physicians categorize the risk of cancer having spread beyond the prostate, or equivalently, the probability of being cured with local therapies such as surgery or radiation. Once patients are placed in prognostic categories, this information can contribute to the selection of an optimal approach to treatment. Prostate cancer stage can be assessed by either clinical or pathological staging methods. Clinical staging usually occurs before the first treatment and tumour presence is determined through imaging and rectal examination, while pathological staging is done after treatment once a biopsy is performed or the prostate is removed by looking at the cell types within the sample.
Prostate cancer screening is the screening process used to detect undiagnosed prostate cancer in men without signs or symptoms. When abnormal prostate tissue or cancer is found early, it may be easier to treat and cure, but it is unclear if early detection reduces mortality rates.
Urology Robotics, or URobotics, is a new interdisciplinary field for the application of robots in urology and for the development of such systems and novel technologies in this clinical discipline. Urology is among the medical fields with the highest rate of technology advances, which for several years has included the use medical robots.
Prostate cancer antigen 3 is a gene that expresses a non-coding RNA. PCA3 is only expressed in human prostate tissue, and the gene is highly overexpressed in prostate cancer. Because of its restricted expression profile, the PCA3 RNA is useful as a tumor marker.
Treatment for prostate cancer may involve active surveillance, surgery, radiation therapy – including brachytherapy and external-beam radiation therapy, proton therapy, high-intensity focused ultrasound (HIFU), cryosurgery, hormonal therapy, chemotherapy, or some combination. Treatments also extend to survivorship based interventions. These interventions are focused on five domains including: physical symptoms, psychological symptoms, surveillance, health promotion and care coordination. However, a published review has found only high levels of evidence for interventions that target physical and psychological symptom management and health promotion, with no reviews of interventions for either care coordination or surveillance. The favored treatment option depends on the stage of the disease, the Gleason score, and the PSA level. Other important factors include the man's age, his general health, and his feelings about potential treatments and their possible side-effects. Because all treatments can have significant side-effects, such as erectile dysfunction and urinary incontinence, treatment discussions often focus on balancing the goals of therapy with the risks of lifestyle alterations.
Active surveillance is a management option for localized prostate cancer that can be offered to appropriate patients who would also be candidates for aggressive local therapies, with the intent to intervene if the disease progresses. Active surveillance should not be confused with watchful waiting, another observational strategy for men that would not be candidates for curative therapy because of a limited life expectancy.
PI-RADS is an acronym for Prostate Imaging Reporting and Data System, defining standards of high-quality clinical service for multi-parametric magnetic resonance imaging (mpMRI), including image creation and reporting.
In the field of medicine, radiomics is a method that extracts a large number of features from medical images using data-characterisation algorithms. These features, termed radiomic features, have the potential to uncover tumoral patterns and characteristics that fail to be appreciated by the naked eye. The hypothesis of radiomics is that the distinctive imaging features between disease forms may be useful for predicting prognosis and therapeutic response for various cancer types, thus providing valuable information for personalized therapy. Radiomics emerged from the medical fields of radiology and oncology and is the most advanced in applications within these fields. However, the technique can be applied to any medical study where a pathological process can be imaged.
If medical treatment is not effective, surgery may need to be performed for benign prostatic hyperplasia.
A PSMA scan is a nuclear medicine imaging technique used in the diagnosis and staging of prostate cancer. It is carried out by injection of a radiopharmaceutical with a positron or gamma emitting radionuclide and a prostate-specific membrane antigen (PSMA) targeting ligand. After injection, imaging of positron emitters such as gallium-68 (68Ga), copper-64 (64Cu), and fluorine-18 (18F) is carried out with a positron emission tomography (PET) scanner. For gamma emitters such as technetium-99m (99mTc) and indium-111 (111In) single-photon emission computed tomography (SPECT) imaging is performed with a gamma camera.
Hashim U. Ahmed is a British surgeon, medical researcher and author of publications in the field of prostate cancer diagnostics and treatment; his research has contributed to changes in the way men with suspected prostate cancer and men with prostate enlargement are diagnosed and treated. He is Professor and Chair of Urology at Imperial College Healthcare NHS Trust and Consultant Urological Surgeon at both Charing Cross Hospital and BUPA Cromwell Hospital.
Padeliporfin, sold under the brand name Tookad, is a medication used to treat men with prostate cancer. It is used in the form padeliporfin di-potassium.
Mark Emberton is a urologist and prostate cancer research specialist using novel imaging techniques and minimally invasive treatments to improve diagnosis and treatment of prostate cancer.