Karan Wadhwa

Mid Essex Hospital Services NHS Trust | meht · Urology

New technologies for the detection of prostate cancer are emerging regularly. The authors summarise recent advances in prostate cancer diagnostics, including serum, urine and tissue markers, and outline improvements in imaging and biopsy techniques.

With the rise in use of cross‐sectional imaging, renal masses are increasingly being diagnosed and present a common referral to the urologist both acutely and on an outpatient basis. This chapter presents a brief overview of the diagnosis and provides guidance on the management of renal masses. The main risk factors for developing renal cancer appe...

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Genetically engineered mouse models of cancer can be used to filter genome-wide expression datasets generated from human tumours, and identify gene expression alterations that are functionally important to cancer development and progression. In this study, we have generated RNASeq data from tumours arising in two established mouse models of prostat...

Emerging data demonstrate homologous recombination (HR) defects in castration-resistant prostate cancers, rendering these tumours sensitive to PARP inhibition. Here we demonstrate a direct requirement for the androgen receptor (AR) to maintain HR gene expression and HR activity in prostate cancer. We show that PARP-mediated repair pathways are upre...

We have previously reported that the negative regulator Similar Expression to FGF (hSef) is down-regulated in prostate cancer and its loss is associated with clinical metastasis. Here, we explored the mechanistic basis of this finding. We first confirmed our clinical observation by testing hSef manipulation in an in vivo metastasis model. hSef stab...

We aimed to determine short-term patient-reported outcomes in men having general anesthetic transperineal (TP) prostate biopsies. A prospective cohort study was performed in men having a diagnostic TP biopsy. This was done using a validated and adapted questionnaire immediately post-biopsy and at follow-up of between 7 and 14 days across three tert...

Background: To assess if transperineal prostate (TP) biopsy affects the outcome of robotic-assisted laparoscopic prostatectomy (RALP), with particular reference to peri-operative complications, oncological results and functional outcomes in the early post operative setting. Methods: We identified 61 men who had undergone RALP after TP biopsies,...

Objective To determine the incidence of prostatic urethral involvement in our patient population and how prostatic urethral biopsy correlates with final cystectomy pathology. Patients and methods We conducted a retrospective review of prostatic urethral biopsies (PUB) performed between February 2008 and April 2012 in a single centre. PUB pathology...

Background: Medical therapy for men with prostate cancer (PCa) is evolving, including recent evidence to support the use of chemotherapy for men with hormone sensitive disease. PI3K/AKT/mTOR pathway aberrations are common in patients with primary PCa and almost universal in metastatic tumours. The mTOR pathway acts as a central regulator of tumour...

Clinical studies have shown the improved benefit of combining androgen deprivation therapy (ADT) with radiotherapy, indicating a potential interaction between the androgen signalling and DNA damage response (DDR) pathways in PCa. We have explored the underlying basis of this interaction by interrogating the mechanism of androgen regulation of the D...

Introduction: The aim of this study was to investigate the effect of three major environmental variables (temperature, humidity, air pressure) on the probability of onset of renal colic (RC) in a large cohort of patients in Rome. Methods: The records of 2682 patients discharged by the Emergency Department (ED) of the University Hospital of Tor V...

Background: Prostate biopsy supported by transperineal image fusion has recently been developed as a new method to the improve accuracy of prostate cancer detection. Objective: To describe the Ginsburg protocol for transperineal prostate biopsy supported by multiparametric magnetic resonance imaging (mpMRI) and transrectal ultrasound (TRUS) imag...

We aimed to determine short-term patient-reported outcomes in men having general anesthetic transperineal (TP) prostate biopsies. A prospective cohort study was performed in men having a diagnostic TP biopsy. This was done using a validated and adapted questionnaire immediately post-biopsy and at follow-up of between 7 and 14 days across three tert...

Introduction: We characterized false negative prostate magnetic resonance imaging (MRI) reporting by using histology derived from MRI-transrectal ultrasound (TRUS)-guided transperineal (MTTP) fusion biopsies. Methods: In total, 148 consecutive patients were retrospectively reviewed. Men underwent multiparametric MRI (mpMRI), reported by a consul...

Background: An estimated 220,800 cases and 27,540 deaths from prostate cancer (PCa) will occur in the USA during 2015. Altered PI3K/AKT/mTOR signalling contributes to prostate cancer progression and transition to androgen-independent disease, for example one study reported 42% of primary and 100% of metastatic PCa tumours exhibited mutations, alter...

An estimated 220,800 cases and 27,540 deaths from prostate cancer (PCa) will occur in the USA during 2015. Altered PI3K/AKT/mTOR signalling contributes to prostate cancer progression and transition to androgen-independent disease, for example one study reported 42% of primary and 100% of metastatic PCa tumours exhibited mutations, altered expressio...

To compare histological outcomes in patients undergoing MRI-transrectal ultrasound fusion transperineal (MTTP) prostate biopsy and determine the incremental benefit of targeted cores. Seventy-six consecutive patients with 89 MRI-identified targets underwent MTTP biopsy. Separate targeted biopsies and background cores were obtained according to a st...

SIK2 is a multifunctional kinase of the AMPK family which plays a role in CREB1-mediated gene transcription and was recently reported to have therapeutic potential in ovarian cancer. The expression of this kinase was investigated in prostate cancer clinical specimens. Interestingly, auto-antibodies against SIK2 were increased in the plasma of patie...

Objectives To determine the accuracy of multiparametric Magnetic Resonance Imaging (mpMRI) during the learning curve of radiologists using MRI targeted, transrectal ultrasound guided transperineal fusion biopsy (MTTP) for validation.Material And Methods Prospective data on 340 men who underwent mpMRI (T2 weighted and DW-MRI) followed by MTTP prosta...

Objectives: To define terms and processes and agree on a minimum dataset in relation to transperineal prostate biopsy procedures and enhanced prostate diagnostics. To identify the need for further evaluation and establish a collaborative research practice. Patients and methods: A 19-member multidisciplinary panel rated 66 items for their appropr...

Live kidney donation is becoming increasingly common as the need for donors is unmet from the deceased donor population. However, there are potential risks to the donor, and careful counselling and rigorous pretransplant assessment are imperative. The authors discuss the ethical implications associated with live organ donation. Copyright © 2013 Joh...

A 69-year-old man presented with sudden onset of macroscopic hematuria. While an ultrasound of the bladder revealed a posterior bladder mass, subsequent flexible cystoscopy demonstrated only an area of irregular urothelium. Initial general anesthetic cytoscopy and biopsy revealed conventional G2/3 T1 TCC. Histology of a further formal resection of...

Testes of hypogonadal (hpg) mice show arrested postnatal development due to congenital deficiencies of gonadotrophin-releasing hormone (GnRH) and gonadotrophin synthesis and secretion. Follicle-stimulating hormone (FSH), androgen or oestrogen treatment restore qualitatively normal spermatogenesis in hpg testes. Understanding the cellular and molecu...