John Fitzpatrick Irish Genitourinary Cancer Conference
On the 6th and 7th April 2017 the 3rd Annual John Fitzpatrick Conference was held in the fantastic Aviva Stadium in Dublin. The meeting was opened by Simon Harris, the Irish Minister of Health, who emphasised the challenges that need to be overcome to provide excellent cancer care for an ever-increasing number of patients in Ireland and beyond, many of whom have significant co-morbidities. He praised the outstanding clinical and scientific work being done in his country on urological malignancies. Professor Lorelei Mucci from the Dana-Faber Harvard Cancer Center in Boston then discussed the molecular epidemiology of prostate cancer. This excellent discourse was followed by a review of the grading systems for prostate cancer, including the Gleason scoring system, which patients often find confusing, and which does have significant observer to observer variation. Stephen Pennington then elaborated on the promise of proteomics for prostate cancer markers, an area that John Fitzpatrick had always been especially interested in.
In the second session Damian Bolton, from Melbourne, reviewed the current diagnosis and staging of prostate cancer; his talk was appropriately followed by that of Uwe Haberkorn from the University of Heidelberg, who discussed the use of PMSA ligands, not only for the diagnosis of extra-prostatic spread of cancer by PET CT scanning, but also as potential therapeutic targets. There seems little doubt that the use of PMSA PET CT scanning is destined to rise significantly as a method of detecting metastases in higher risk de novo cases of prostate cancer, and also in men with PSA recurrence after either surgery or radiotherapy. The first day concluded with a tribute to Professor John Fitzpatrick, whose memory is still revered in Dublin, and indeed across the globe, by urologists and all those interested in the scientific basis of urological malignancy.
Day two of this impressive meeting focused on bladder cancer, the highlights of which included a state-of-the-art talk on treatment with organ preservation by radiotherapy by Bill Shipley, widely regarded as the Father of this treatment modality. Dean Bajorin from the Memorial Sloan Kettering Cancer Centre (MSKCC) New York then gave a masterly review of new systemic therapies for advanced bladder cancer, many of which are beginning to look highly promising, and may well transform clinical outcomes.
Renal cell cancer (RCC) was the next subject covered, on this occasion by Martin Voss, again from MSKCC, and his outstanding talk reviewed the use of Sunitinib, Axitinib and Sorafinib in this context. All these agents have been shown to result on prolongation of overall survival in patients with metastatic RCC, but are associated with some troublesome side-effects.
Damian Bolton, who was a close friend of John Fitzpatrick, then discussed the role of BRCA 1 and 2 DNA repair gene mutations in relation to prostate and breast cancer susceptibility.
Other speakers who had travelled all the way from Australia included Nathan Lawrenschuk from the new Peter MacCullum Cancer Centre in Melbourne, who gave two excellent talks on the PMSA PET CT imaging in relation to salvage lymph node dissection and partial orchidectomy, as well as less invasive radical orchidectomy.
Plans are already being made for next year’s John Fitzpatrick Irish Genitourinary Conference next April. Why not come along to the meeting and also enjoy the fair city of Dublin?