Jonathan Hugh Waxman OBE (born 1951), [1] founder and president of Prostate Cancer UK, [2] is emeritus Professor of Oncology at Imperial College London, [3] [4] and author of four novels including The Elephant in the Room. He is a clinician who has helped develop new treatments for cancer, which are now part of standard practice. [2] [5]
Jonathan Waxman was born in 1951 in Hampstead, London. His father was a psychiatrist who worked at the Central Middlesex Hospital. [5] He was educated at Haberdashers' Aske's School, Elstree, and at age of 17 he went to University College London Medical School, winning a scholarship and two prizes. After qualification as a doctor he worked briefly in Cambridge before returning to the capital and finding employment in North London Teaching hospitals.
In 1981 Waxman embarked upon post-graduate research at St Bartholomew's Hospital, London, beginning by studying the effects of chemotherapy on fertility in cancer patients. He found that patients with lymphoma were sterilised by treatment; they were cured of the cancer but rendered infertile.
By coincidence, a new drug had been under development that was intended to stimulate puberty. When tested in animals however it was found to have the opposite effect and further development had been stopped. Waxman used the drug to switch off the activity of testes and ovaries in patients about to have chemotherapy, in the hope that it would prevent its sterilising effect.
Recognizing its potential, he then used the drug in cancers where tumour growth depended upon the hormones made by the testes and ovaries. He found the drug – a Gonadotropin-releasing hormone agonist – to be active in prostate cancer. He was the first clinician in Europe to report the clinical effects of this new medicine which, 30 years on, is still the drug of first choice in the treatment of patients with prostate cancer. The drug replaced castration which was the treatment at the time, providing a humane alternative to surgery. [5] [6]
In 1986, Waxman became a consultant at the Hammersmith Hospital, moving to Imperial College in 2011 where he became the Flow Foundation Professor of Oncology. [3] He established a clinical and laboratory research program, leading a laboratory research team with the goal to understand the mechanisms underlying the growth of prostate cancer, whilst continuing to carry out duties in the clinical environment. [5] Active in the care of patients and running numerous clinical trials, Waxman has published around 400 research papers and book chapters, and 16 books on cancer.
In 1996 Waxman established The Prostate Cancer Charity, the first United Kingdom national organisation promoting research and patient support for prostate cancer. [3] The organisation has since merged with Prostate Action, becoming Prostate Cancer UK, the biggest organisation of its kind in the UK. In 2014 the organisation employed 170 people and had an annual income of £32 million. [7] Prostate Cancer UK lobbies for change in the environment for prostate cancer patients, funds research and provides a national and regional patient support and information service. Prostate Cancer UK is a beneficiary of the Movember Appeal, a multinational organisation dedicated to improving men's health. [8]
Jonathan helped establish the All-party Parliamentary Group on Cancer, the organisation behind the Britain Against Cancer movement. He has also written a medical law book, a novel and a book of short stories entitled The Elephant in the Room, published in October 2011.
The Elephant in the Room was inspired by J. G. Ballard, author of Empire of the Sun and Crash. Waxman treated Ballard for prostate cancer until his death in 2009, and their treatment room conversations led to the proposal of a co-written book to be titled Conversations with my Physician: the Meaning, if any, of Life. When Ballard became too ill to complete the book, Waxman decided to finish it in tribute to his friend. [5] [9]
Waxman has written for a number of national newspapers [10] and frequently appears on TV and radio to comment on health matters. [11]
Waxman was appointed Officer of the Order of the British Empire (OBE) in the 2023 New Year Honours for services to prostate cancer awareness and treatment. [12]
Diethylstilbestrol (DES), also known as stilbestrol or stilboestrol, is a nonsteroidal estrogen medication, which is presently rarely used. In the past, it was widely used for a variety of indications, including pregnancy support for those with a history of recurrent miscarriage, hormone therapy for menopausal symptoms and estrogen deficiency, treatment of prostate cancer and breast cancer, and other uses. By 2007, it was only used in the treatment of prostate cancer and breast cancer. In 2011, Hoover and colleagues reported on adverse health outcomes linked to DES including infertility, miscarriage, ectopic pregnancy, preeclampsia, preterm birth, stillbirth, infant death, menopause prior to age 45, breast cancer, cervical cancer, and vaginal cancer. While most commonly taken by mouth, DES was available for use by other routes as well, for instance, vaginal, topical, and by injection.
Cancer Research UK (CRUK) is the world's largest independent cancer research organisation. It is registered as a charity in the United Kingdom and Isle of Man, and was formed on 4 February 2002 by the merger of The Cancer Research Campaign and the Imperial Cancer Research Fund. Cancer Research UK conducts research using both its own staff and grant-funded researchers. It also provides information about cancer and runs campaigns aimed at raising awareness and influencing public policy.
The Institute of Cancer Research is a public research institute and a member institution of the University of London in London, United Kingdom, specialising in oncology. It was founded in 1909 as a research department of the Royal Marsden Hospital and joined the University of London in 2003. It has been responsible for a number of breakthrough discoveries, including that the basic cause of cancer is damage to DNA.
Bicalutamide, sold under the brand name Casodex among others, is an antiandrogen medication that is primarily used to treat prostate cancer. It is typically used together with a gonadotropin-releasing hormone (GnRH) analogue or surgical removal of the testicles to treat metastatic prostate cancer (mPC). To a lesser extent, it is used at high doses for locally advanced prostate cancer (LAPC) as a monotherapy without castration. Bicalutamide was also previously used as monotherapy to treat localized prostate cancer (LPC), but authorization for this use was withdrawn following unfavorable trial findings. Besides prostate cancer, bicalutamide is limitedly used in the treatment of excessive hair growth and scalp hair loss in women, as a puberty blocker and component of feminizing hormone therapy for transgender girls and women, to treat gonadotropin-independent early puberty in boys, and to prevent overly long-lasting erections in men. It is taken by mouth.
Polyestradiol phosphate (PEP), sold under the brand name Estradurin, is an estrogen medication which is used primarily in the treatment of prostate cancer in men. It is also used in women to treat breast cancer, as a component of hormone therapy to treat low estrogen levels and menopausal symptoms, and as a component of feminizing hormone therapy for transgender women. It is given by injection into muscle once every four weeks.
Flutamide, sold under the brand name Eulexin among others, is a nonsteroidal antiandrogen (NSAA) which is used primarily to treat prostate cancer. It is also used in the treatment of androgen-dependent conditions like acne, excessive hair growth, and high androgen levels in women. It is taken by mouth, usually three times per day.
Gonadotropin-releasing hormone antagonists are a class of medications that antagonize the gonadotropin-releasing hormone receptor and thus the action of gonadotropin-releasing hormone (GnRH). They are used in the treatment of prostate cancer, endometriosis, uterine fibroids, female infertility in assisted reproduction, and for other indications.
Reproductive medicine is a branch of medicine concerning the male and female reproductive systems. It encompasses a variety of reproductive conditions, their prevention and assessment, as well as their subsequent treatment and prognosis.
Antihormone therapy is a type of hormone therapy that suppresses selected hormones or their effects, in contrast with hormone replacement therapy, which encourages hormone activity.
Enzalutamide, sold under the brand name Xtandi, is a nonsteroidal antiandrogen (NSAA) medication which is used in the treatment of prostate cancer. It is indicated for use in conjunction with castration in the treatment of metastatic castration-resistant prostate cancer (mCRPC), nonmetastatic castration-resistant prostate cancer, and metastatic castration-sensitive prostate cancer (mCSPC). It is taken by mouth.
The Prostate Cancer Foundation (PCF), headquartered in Santa Monica, California, funds research into the prevention and cure of prostate cancer.
Karol Sikora is a British physician specialising in oncology, who has been described as a leading world authority on cancer. He was a founder and medical director of Rutherford Health, a company that provided proton therapy services, and is Director of Medical Oncology at the Bahamas Cancer Centre.
Cabazitaxel, sold under the brand name Jevtana, is a semi-synthetic derivative of a natural taxoid. It is a microtubule inhibitor, and the fourth taxane to be approved as a cancer therapy.
Sipuleucel-T, sold under the brand name Provenge, developed by Dendreon Pharmaceuticals, LLC, is a cell-based cancer immunotherapy for prostate cancer (CaP). It is an autologous cellular immunotherapy.
Roger Sinclair Kirby FRCS(Urol), FEBU is a British retired prostate surgeon and professor of urology, researcher, writer on men's health and prostate disease, founding editor of the journal Prostate Cancer and Prostatic Diseases and Trends in Urology and Men's Health and a fundraiser for prostate disease charities, best known for his use of the da Vinci surgical robot for laparoscopic prostatectomy in the treatment of prostate cancer. He is a co-founder and president of the charity The Urology Foundation (TUF), vice-president of the charity Prostate Cancer UK, trustee of the King Edward VII's Hospital and as of 2020 is president of the Royal Society of Medicine (RSM), London.
Colleen Nelson is a scientist in prostate cancer research. She founded and directs the Australian Prostate Cancer Research Centre – Queensland (APCRC-Q). The Centre, based at the Translational Research Institute and the Princess Alexandra Hospital, spans the spectrum of discovery of new therapeutic targets and their preclinical and clinical development. She is also Chair of Prostate Cancer Research at Queensland University of Technology (QUT).
A nonsteroidal antiandrogen (NSAA) is an antiandrogen with a nonsteroidal chemical structure. They are typically selective and full or silent antagonists of the androgen receptor (AR) and act by directly blocking the effects of androgens like testosterone and dihydrotestosterone (DHT). NSAAs are used in the treatment of androgen-dependent conditions in men and women. They are the converse of steroidal antiandrogens (SAAs), which are antiandrogens that are steroids and are structurally related to testosterone.
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.
Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy (STAMPEDE) is a clinical trial investigating treatments for high risk or terminal prostate cancer. Recruitment started in 2005 and ends in 2022 and in January 2020, over 10,000 participants have joined the trial.
Prostate Cancer UK is a prostate cancer research, awareness and support organisation which is a registered charity in England and Wales, as well as in Scotland.