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Title: Evaluating intra-prostatic interstitial treatments in the management of localised prostate cancer
Author: Shanmugabavan, Yaalini
ISNI:       0000 0004 8507 5406
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2019
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This body of work interrogates the current diagnostic and management pathway a man with localised prostate cancer would undergo. Localised Prostate cancer has undergone a diagnostic revolution with the advent of Multiparametric MRIs (mpMRIs), template prostate mapping (TPM) and targeted biopsies. This has led to better characterisation of Prostate cancer burden and therefore a tailored and appropriate management plan for such men. I have analysed the shift in clinical management for men who undergo TPM biopsy when compared to the standard TRUS biopsy. Also, with better characterisation of disease we can confidently identify pure Gleason 6 disease. With increasing calls for this entity to be relabelled as non-cancer entity, I evaluated the natural history of this disease in the medium term to evaluate one hallmark of cancer (that is histological progression and metastases). Whole gland therapy is the gold standard for men with prostate cancer, but with better risk stratification and characterisation, we are able to treat cancer focally in order to derive oncological control whilst preserving surrounding tissue for reduced functional impact. My body of work looks at targeted interstitial injections of a drug and nanoparticle technology to focally ablate the tumour. I conducted a proof-ofconcept study for the use of nanoparticles in the thermo-ablation of localised prostate cancer. Also, how we achieve thermo-ablation temperature through electromagnetic fields generated by coils placed across a phantom prostate. I also conducted a first-in-man, phase IIb trial, when a drug (PRX302) is injected directly into the tumour, which induces cell death in the presence of prostatic PSA. We evaluated the adverse events and toxicity burden as well as histological response post-treatment to determine whether further work should be carried out.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available