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ANDROGENS, THE PROSTATE AND THE IMPACT OF NEOPLASIA   

Mr Mark Feneley

Institute of Urology, University College

London, UK

The rising incidence of prostate cancer has made this the commonest non-cutaneous malignancy affecting men in the USA. Its sensitivity to endocrine manipulation described by Huggins in 1941 still represents the most significant therapeutic advance in the past 60 years. Since then improved detection and earlier diagnosis has brought about a dramatic stage shift at presentation, with substantial clinical and therapeutic consequences. This has also provided opportunities to study and understand the biology of disease at an early and previously obscure stage. Early events in prostatic carcinogenesis present a tumour profile very different from that selected by metastatic progression and androgen deprivation in association with advanced stage. The role of androgens and androgen signaling pathways in the prostate will be considered in relation to the development and progression of malignancy, and with particular reference to therapeutic implications.

Mr Mark R Feneley, MD, FRCS, FRCS (Urol)

Institute of Urology, University College

London, UK

Mark Feneley graduated from Cambridge University and completed his basic medical training in London. His MD degree was awarded at Cambridge for research into the early diagnosis of prostate cancer, and received his Hunterian Professorship at the Royal College of Surgeons of England. After completing higher Urological training at St Bartholomew’s and the Royal London Hospitals, London, he accepted a two-year post-doctoral fellowship in Urological Oncology at the Brady Urological Institute, Johns Hopkins Hospital, USA. He then worked as a Consultant Urologist subspecialising in urological malignancy at Nottingham City Hospital and was there appointed Director of Postgraduate Education. In 2003, he began his present position as Consultant Urological Oncological Surgeon at the Institute of Urology, UCLH, London. Research interests include benign and malignant prostatic disease, PSA testing, biology of early prostate cancer and antibody targeting for imaging, with extensive publications in these fields.

Recent references

            1.             Feneley MR, Landis P, Simon I, Metter EJ, Morrell CH, Carter HB et al. Today men with prostate cancer have larger prostates. Urology 2000;56:839-42.

            2.             Feneley MR, Jan H, Granowska M, Mather SJ, Ellison D, Glass J et al. Imaging with prostate-specific membrane antigen (PSMA) in prostate cancer. Prostate Cancer Prostatic.Dis. 2000;3:47-52.

            3.             Feneley MR, Span PN, Schalken JA, Harper M, Griffiths K, Holmes K et al. A prospective randomized trial evaluating tissue effects of finasteride therapy in benign prostatic hyperplasia. Prostate Cancer Prostatic.Dis. 1999;2:277-81.

            4.             Feneley MR,.Walsh PC. Incontinence after radical prostatectomy. Lancet 1999;353:2091-2.

            5.             Feneley MR,.Feneley RC. Funding clinical research: the need for information and longer term strategies. Ann.R.Coll.Surg.Eng 1999.

            6.             Feneley MR. Does screening for prostate cancer identify clinically important disease? Ann.R.Coll.Surg.Engl. 1999;81:207-14.

            7.             Feneley MR, Green JS, Young MP, Bose P, Kirby RS, Peeling WB et al. Prevalence of prostatic intra-epithelial neoplasia (PIN) in biopsies from hospital practice and pilot screening: clinical implications. Prostate Cancer Prostatic.Dis. 1997;1:79-83.