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Robot leads the way in prostate cancer fight

Men in the west of Scotland are being given access to world-leading robotic technology in the fight against prostate cancer. 

Prostate cancer is the most common cancer amongst men in Scotland and 1 in 10 Scottish men are likely to develop the disease. 

Now, as the result of a partnership between West of Scotland Health Boards, the ‎Scottish Government and Prostate Scotland, NHS Greater Glasgow & Clyde is able to offer radical prostatectomies using robotics. It is hoped that around 300 men each year will benefit from this new technology. 

Consultant Urologist Mr Hasan Qazi said: “Until recently, men with prostate cancer had few surgery choices, which predominantly involved an open prostatectomy, involving large incisions, higher blood loss, slower return to continence and in general, a longer period of convalescence.  

“With the new state of the art Da-Vinci Xi Dual console system at the Queen Elizabeth University Hospital, we hope to facilitate better results for men undergoing radical prostatectomy, in getting them cancer free and continent early after surgery and where possible, preserving potency. This represents a huge development for Cancer Surgery in Scotland.” 

The service, in the new Queen Elizabeth University ‎Hospital, now provides access to this world leading technology for patients across the West of Scotland and will be opened up to even more men from April this year.  

In excess of £2million has been invested in this development‎, including a commitment of £1million from Scottish Government funding.  Prostate Scotland, a Scottish charity set up to provide information, advice and to support treatment advancements on prostate disease, has raised a sizeable sum to provide specialist decontamination equipment for the robotic programme. 

Health Secretary Shona Robison said: “Our investment of £1 million towards this state-of-the-art technology in Glasgow will further ensure men have access to the most advanced treatment available, as well as leading to shorter lengths of stay in hospital and a speedy return to everyday life. 

“This funding follows on from our previous investment of £1 million to assist NHS Grampian with purchasing a robot for Aberdeen Royal Infirmary. Plans are also being explored for a robot in the east of Scotland, with the Scottish Government committing up to £1 million for this future initiative. 

“We have seen a welcome increase in the number of men surviving prostate cancer in recent of years, and our investment in robot- assisted prostate cancer surgery is aimed at helping improve functional outcomes and increase the survival rate even further.” 

Robert Wilson, Chairman of Prostate Scotland said: “Prostate cancer is the most common cancer in men in Scotland and it is therefore great news that soon men in the West of Scotland will have access to robot assisted surgery for prostate cancer and we welcome this significant step forward in treatment options for men with prostate cancer.  

“We are pleased to have been able, through our Blue Horizon Robot Appeal, to make a contribution towards the equipment costs for the robotic programme in the West and would like to thank our many donors for their support towards this.”  

Initiative providing ICU patients support through InSPIRE
An initiative in the Intensive Care Unit (ICU) at Glasgow Royal Infirmary (GRI) has been piloting a recovery programme for patients who have been cared for in ICU. 

ICU patients can have persistent physical and psychological problems as a direct result of the intensive care stay which can impact all aspects of their life.  The InSPIRE (Intensive Care Recovery: Supporting and Promoting Independence and Return to Employment) project is a five week rehabilitation and support initiative for ICU patients and their families.

The joint initiative between NHS Greater Glasgow and Clyde (NHSGGC) and the University of Glasgow has been chosen to be part of the Shine programme from the independent health care charity the Health Foundation and has been chosen for a national award for its work with ICU patients.

Through Shine, the Health Foundation is supporting 23 teams with outstanding, innovative ideas that aim to tackle the current challenges within the health service of which the InSPIRE initiative is one.

The joint initiative is led by a team from GRI ICU with support from the Health and Social Care Alliance Scotland and over the course of the next year the project team will be developing and testing their innovation, putting it into practice, and gathering evidence about its impact and effectiveness.

Dr Tara Quasim, ICU Consultant, GRI said:  'We are delighted to be supported by the Health Foundation. 

“This innovative project we hope will change many people’s lives who have been cared for in ICU.  ICU survivors can have persistent physical and psychological problems as a direct result of their intensive care stay, which can have an impact all aspects of their life. 

“We hope that this innovative programme will navigate patients in their recovery, by giving both patients and family member’s access to appropriate services and support.”

Professor John Kinsella, University of Glasgow, added:  “It is clear that intensive care has made tremendous progress in the last 20 years. 

“Many more people are now surviving due to research and better care.  This is very welcome but the survivors of prolonged critical illness face many challenges in the weeks and months after discharge home.  All the progress in improving survival is only worthwhile if we do everything possible to improve the health and wellbeing of the intensive care survivors, allowing them to return to a full role in society.

“Every patient faces different challenges. This program facilitates the patient getting the support that they actually need.

“The success of modern medicine should be measured in terms of how the needs of every individual patient are met. The InSPIRE program puts the patient first.”

Funding to increase MS clinical trials in Scotland 
A new multiple sclerosis clinical trials unit being set up in Glasgow which will give Scots sufferers access to cutting edge medical treatments for the disease has been welcomed by patients and specialists. 

Scotland is home to one of the highest incidences of multiple sclerosis (MS) in the world with more than 10,000 people affected. 

The new clinical trials unit will give research into the debilitating condition a much needed boost thanks to funding from the Chief Scientist Office (CSO) of the Scottish Government Health and Social Care Directorates as part of a national initiative called NHS Research Scotland (NRS).

NHS Greater Glashow and Clyde Consultant Neurologist, James Overell, based at the Institute of Neuroscience at the Southern General in Glasgow, has been awarded a three-year NRS Career Research Fellowship to test new treatments for MS.  Further support for these trials will come via NRS Infrastructure funding allocated to the Health Board by CSO.

Dr Overell explained:  “This is a very exciting time in MS research and there are many opportunities to try new drugs that are proving to be effective with less risk and fewer side effects.  Our MS patients deserve the choice to try these new treatment options.  For some who are experiencing the secondary progressive part of the condition, trials for new drugs are their only option.

“In Scotland we have the highest incidence of MS in the world.  We have a large number of patients and drug companies want to come here – we really do have the opportunity to do some amazing work and help people try new therapies and to tackle this degenerative disease.”

One of the patients who hope to benefit from the new clinical trials unit is 37-year-old Suzanne McLean who is expecting her first child in August.  Suzanne who lives in Coatbridge explained:  “Having MS and hoping to find something which will delay or even cure symptoms has become more of an issue since becoming pregnant, obviously I want to be able to do all the things that every mum does with her baby and I want to be able to think ahead to when my child is growing up.  I want to be able to run around after them.

“Having MS hasn’t stopped me from doing things, I‘ve just tried to keep going and just live my life.  But the trials unit is very important as we need to test new drugs and therapies to give more options to people like me now and in the future.”

Sadly it is not at all uncommon for people to be diagnosed with MS in young adult life, when Dr Overell points out they are becoming established in careers, getting married and starting families. 

“I can diagnose up to five people a week with the condition.  But their main concern often is not always for the here and now but what will happen to them later in life.  Will they be in a wheelchair by the time they are 50?”

Dr Overell continued:  “We have seen in recent years that more drugs are available to help with the relapse and remission stage of the disease and people can stay in this stage for 20 years before moving into secondary progression.  We need to start looking at these newer drugs to see whether if taken earlier or for longer they could have an impact in delaying secondary progression. We also need to look at developing drugs specifically to treat this secondary part of the disease.”

The announcement was welcomed by the Cabinet Secretary for Health Alex Neil who said:  “The Scottish Government recognises that Multiple Sclerosis is a debilitating condition that has significant impact on the Scottish people, and is committed to providing the best possible care and support for people living with MS.  Providing access to clinical trials for MS patients, through Dr Overell’s Fellowship, is part of that commitment.”

While there is no guarantee that the experimental treatments offered through the trials will have positive outcomes, it is well recognised that patients who are part of clinical trials contribute to research overall and can help improve outcomes for others.  That is why the Chief Scientist Office is investing £6m over four years to support 67 NRS Clinical Research Fellows in a wide range of clinical areas, so that as many patients are offered the opportunity to participate in a clinical trial in the relevant condition.

Scotland already has a research centre in Edinburgh for Multiple Sclerosis, the Anne Rowling Regenerative Neurogology Clinic, which is conducting pre-clinical research into many potentially beneficial therapies for MS.  Dr Overell sees this work as being essential and complementary to the new Unit in Glasgow.

“What we hope to do is take the lab based work and evolve it into clinical trials, and work in partnership with the Anne Rowling Centre to come up with a Scottish solution to this problem which affects so many of our population. 

“The Unit will be able to give patients access to experimental treatments first and faster, although it must be recognised that these are research studies, and any positive outcomes may take some years to be taken up as standard clinical practice.  The majority of people we see affected by MS are well-informed people who know there are new treatments out there.  They’ve been frustrated for years that they don’t have the opportunity to take part in trial programmes to try and sustain their quality of life longer.

“Unlike a lot of other illnesses for which there are no new drug options available, MS is a growth area and with this funding from the Chief Scientist Office, we can have time to build something which could make real headway into helping people with MS live the lives they want, and deserve, for longer.”

Ground breaking research into stroke
Researchers in Glasgow are leading on a new ground breaking trial which could revolutionize the way we diagnose and treat stroke within the next five years.  

Southern General neuroradiologist Dr Celestine Santosh and the team at the hospital’s neuro radiology department, department of clinical physics and the University of Glasgow are working on developing new technologies to help diagnose and treat stroke more effectively and within wider time frames using oxygen, perflourocarbon (PFC) as an efficient oxygen carrier, and MRI scans.

The aim of management in acute stroke is to identify and treat the “penumbra”.  The penumbra consists of the viable tissues that surround the dead area in the brain after stroke which would also die if not treated

Dr Santosh explained:  “Currently every clinician is treating acute stroke with clot buster drugs while always watching the clock as this treatment is only licensed for use up to 4.5 hours after stroke.  

“This obviously has major limitations as one third of all stroke patients don’t know the time of their onset of symptoms.  However, research shows that the penumbra can stay viable up to 48 hours after a stroke so it gives us more, much needed, valuable time to treat the patient.

“Therefore accurately identifying the penumbra is really the Holy Grail in stroke.  The Glasgow team has developed a novel technique called Glasgow Oxygen Level Dependent (GOLD) which uses an MRI scanner, PFC and oxygen to identify this penumbra.  Furthermore by efficiently delivering oxygen with the PFC to the tissue that has been starved of oxygen, it also offers neuro protection.  GOLD uniquely combines both therapeutic and diagnostic capabilities and so is uniquely theranostic and could make a real difference to stroke patients.”

As part of the ongoing work before starting the first human stroke trials in Glasgow in 2015, Dr Santosh and his team are working with an American company using their PFC “oxygen carrier” which has already undergone human phase 1 trials.

Dr Santosh explained:  “This is the newest thing on the horizon for stroke care and it has been achieved within a relatively small budget.  We are very proud this is an NHS project, led by the NHS and funded through numerous awards and grants including support from Scottish Health Innovations Limited (SHIL) and recently acknowledged by Scottish Enterprise.  I have had a lot of support from NHS colleagues, in particular physicist Dr David Brennan, with whom I was recently awarded the Scottish Life Sciences Award 2013 for the Best Innovation Originating within NHSScotland. 

“We realise this is a unique project which has the possibility to change the way we diagnose and treat stroke.  It is a giant step forward in stroke treatment and is simply a no brainer for research; we need to look at giving oxygen to viable tissue so that time is no longer the surrogate marker.  If it works here, there are also other conditions we can begin to look at using this treatment for including cardiac and cancer.”

New sensor for diagnosis of infectious diseases being developed with Glasgow University 
A University of Glasgow professor has received funding to develop a new type of sensor to diagnose infectious diseases.  

Jon Cooper, Professor of Bioelectronics and Bioengineering at the University, will work with colleagues at NHS Greater Glasgow and Clyde to develop a new generation of portable devices capable of quickly and accurately determining the cause of an infection.

The sensor, which uses sound energy to power molecular reactions, is being developed to help diagnosis of genital ulcer disease, which affects millions of people worldwide and greatly increases the risk of HIV infection.

It could be used for a range of medical conditions including home kits for sexual health and GP-based tests for respiratory disease.

Professor Cooper said: “We’ve received almost £60,000 from NHS Greater and Glasgow and Clyde to benchmark this technology against existing methods already in use by doctors.  It’s the first step towards turning the results of research into a commercially-available product.

“The sensors we’re developing have a great deal of potential for delivering healthcare in the developed and developing world, as well as field testing for food standards, veterinary health and environmental biomarkers.”

Professor Cooper will be joined on the project by Dr Julien Reboud and Dr Rab Wilson of the Biomedical Research Division of the University’s School of Engineering, Dr Andrew Winter of NHS Greater Glasgow and Clyde’s Sandyford Sexual Health service, and Dr Rory Gunson of the West of Scotland Specialist Virus Laboratory.

Dr Winter commented: “This is a unique collaboration between bio-engineers, clinicians and molecular virologists to bring sensitive modern laboratory tests to the bedside. It has real potential to transform the way we diagnose sexually transmitted infections and other infectious disease, both here and abroad.”