Prostate cancer (PCa) is the commonest male cancer, representing 25% of all male neoplasms in the UK alone. The mainstay of histological diagnosis remains a transrectal ultrasound guided prostate biopsies. Over 1 million transrectal biopsies are performed annually in the US and Europe. However, these are associated with unacceptably high risks of infection, with fevers or chills reported in over 10% and severe sepsis in 1-2%. Costs associated with UK hospitalisation episodes for biopsy-related sepsis alone are estimated to be £7-11million annually. This is thus a major safety concern for health services globally every year. Transperineal (TP) biopsies are much less risky but is more painful as the needles passes through perineal skin and pelvic-floor musculature hence usually necessitating a general anaesthetic or sedation. As a result, there has been a concerted effort by many clinicians to explore how this can be done under local anaesthetic.
Current device options however are much costly than transrectal biopsy methods and reported to use significant amounts of local anaesthetic. These issues have meant slow or no adoption of transperineal biopsy methods in many cash-strapped health care systems. There is thus an imperative need to eliminate the risk of infection inherent in transrectal biopsies while maintaining its simplicity, wider accessibility and low cost suitable for the routine outpatient setting. T o address this, the CAMbridge PROstate Biopsy DevicE – CamPROBE was developed based on the 2 simple concept of a co-axial cannula, but designed specifically for transperineal prostate biopsies using low amounts of local anaesthetic. In clinical development and multi-trials, we have shown the CamPROBE method and device is safe, transferable and maintains high diagnostic yields compared to current methods of biopsy.
The procedure is well tolerated and accepted by patients, ideally suited to the out-patients setting and offers a cost-efficient solution to directly replace transrectal biopsies in any health care setting. We present here the rationale, development and outcome of this simple yet novel solution to achieve infection free prostate biopsies as the new standard of care.
Speaker: Professor Vincent Gnanapragasam, JEB Technologies
Vincent J Gnanapragasam is Professor of Urology and an Honorary Consultant Urologist in the University of Cambridge, UK. Vincent’s research has covered the full spectrum of basic science, translational, clinical and epidemiological disciplines in prostate cancer. He has developed and led numerous investigators led multicentre trials and established the Cambridge Urology Translational Research and Clinical Trials office. His current clinical practice is based on the diagnosis and management of early prostate cancer including diagnostics, prognostic stratification and optimal strategies for surveillance. In this space he has introduced practice changing innovations which have achieved CE mark and national adoption.
Location: UK Presentation Theatre: Hall 16, J48