In the rapidly evolving landscape of healthcare, few topics have garnered as much attention and controversy as prostate cancer screening in the UK. With approximately one in six men destined to face this diagnosis in their lifetime, the urgency to address this issue is undeniable. To provide clarity amidst this complexity, Rebecca Wright, Honorary GP Teaching Fellow at the School of Public Health, and Azeem Majeed, Professor of Primary Care and Public Health, and Head of the Department of Primary Care & Public Health, at Imperial College London, delve into the heart of this debate, seeking to balance the critical factors of risks, resources, and outcomes in prostate cancer screening in England.
Prostate cancer screening in England has become very topical and attracted considerable recent news coverage. Around one in six men will get prostate cancer at some point in their lives with incidence increasing with age. Another major risk factor is ethnicity; black men are at highest risk of prostate cancer and Asian men are at lowest risk. Other risk factors include family history, obesity and genetics; for example, those with a fault in their BRCA 2 gene (genes that produce proteins that help repair damaged DNA) have a two times higher risk of developing prostate cancer. (1)
When Imperial alumnus Dr Brian Wang founded In2MedSchool, he had one aim: to break down the barriers preventing students from disadvantaged backgrounds pursuing medicine. Brian shares his motivations for supporting the next generation of medics.
In the summer of 2022, before my final year of medical school, I had the opportunity to support the national efforts against the COVID-19 pandemic at Imperial College Healthcare Trust NHS hospitals. My experiences as a medical student and volunteer during this time kick-started my passion for advocating diversity within the healthcare workforce. Levelling the playing field and ensuring the diversity and representation of medical staff—in my mind at least—seems beneficial to the healthcare workforce and the communities that our healthcare system supports.
Today I am the founder of In2MedSchool, a charity that provides support for disadvantaged children with ambitions to study Medicine and healthcare-related degrees at university.
In April 1982, I was a young doctor with an interest in infectious diseases when my mentor, Professor Philip Marsden, mentioned a new disease he’d seen in New York, which was affecting young gay men and had all the hallmarks of a sexually transmitted infection. He suggested it would be interesting to look for this new disease in London and he thought St Mary’s Hospital might be a good starting point. So in August 1982, I joined Dr Willie Harris’ Praed St Clinic, looking at the immune system of gay men who visited the clinic, guided by immunologist Professor Tony Pinching and virologist Professor Don Jeffries.
I was fortunate to be able to work on my research full-time from early 1983, thanks to a fellowship from the Wellcome Trust; I had gathered a cohort of 400 gay men at the clinic and examined their immune systems. What my colleagues and I discovered was that all the men in the cohort had abnormal immune systems; they all had a low number of CD4+ T-lymphocytes and low CD4:CD8 T-cell ratios. They also had enlarged lymph nodes in their necks, armpits and groin, which is usually a sign that the body is trying to fight an infection. These observations led us to believe that all the patients in this cohort had an early manifestation of AIDS; it was a chilling insight into the scale of the unfolding AIDS epidemic. (more…)
Professor Jane Davies reflects on the positive news for those affected by cystic fibrosis on both sides of the Atlantic – access to Orkambi on the NHS and FDA Approval of ‘triple combination’ in the US.
Last week marked a milestone for people living with cystic fibrosis (CF) in the UK after NHS England announced that new drugs – Orkambi and Symkevi – will be made available on the NHS after securing a deal with the drug manufacturers, Vertex. After four years of community and patient organisation campaigns, I am delighted with this outcome which will be transformative for young people with CF.
There are over 10,000 people in the UK and over 100,000 worldwide estimated to be living with cystic fibrosis (CF). The condition is caused by a faulty gene encoding for a cell surface ion channel called Cystic Fibrosis Transmembrane Conductance Regulator (CFTR). Ion channels are integral for regulating salt and water transport across mucosal surfaces, particularly in the lungs for defence against infections and in the digestive system. People with CF have a shorter life expectancy than healthy people and a hugely burdensome treatment regime just to keep as well as possible. (more…)
As a registrar working with consultant geriatrician Dr Michael Fertleman, I was increasingly called to the trauma ward to offer geriatric assessments to patients who struggled with multiple issues. Best practice is to give a patient with suspected frailty a comprehensive geriatric assessment within 72 hours, but the volume of patients we receive who qualify has grown so much that this cannot be done without having a consultant geriatrician embedded in the service full time.
As a result, I became the first geriatrician in London to run a dedicated, embedded service in the trauma department. I will sit in the multidisciplinary team meeting with trauma surgeons, go on joint ward rounds with them throughout the week, and see major trauma patients whenever I am needed. I also help look after our surgical rehabilitation ward, which is for patients who are stable but require a longer period in hospital to recover. It is very rewarding to be able to offer continuity of care to our older trauma patients. (more…)
At a time when the NHS faces unprecedented workload and funding pressures, health professionals and the public all recognise the need to make the most efficient use of the resources available to the NHS; and prioritising key clinical areas such as cancer care. Prescribing costs in primary care, currently around £10bn annually, are a key component of the NHS budget in England. It is therefore entirely appropriate to look at this area to see where savings can be made without compromising patient care. (more…)
Dr William (Bill) Frankland, aged 106, has helped transform our understanding of allergies during his long career in medicine. A pioneer in the field, Dr Frankland popularised the pollen count to help clinicians and patients understand what triggers their seasonal allergies. Originally published on the Imperial College Healthcare NHS Trust blog and reproduced here with permission, he reflects on his career and working for the NHS for 70 years.
People often ask me, how is it that I’ve lived until 106. All I can say is I’ve come close to death so many times but somehow I’ve always managed to miss it and that’s why I’m still here.
I was born in 1912, six weeks early. My identical twin brother and I weighed three pounds one ounce each but we both survived – he died in 1995, at age 83. As an early baby, that’s the first time I survived against the odds.
I first encountered hay fever when I was a child. I grew up in the Lake District where my brother and I spent our summers helping a local farmer with his hay. One day, I told my brother my eyes were itchy and I couldn’t go on. “You’re feeble,” he said. It took me 30 years before I realised I had a real problem with summer hay fever and about 90 years to grow out of that allergy.
Healthcare and Design MSc student Peter White makes the case for why we need to think outside the box when it comes to innovation in healthcare.
Have you ever looked at something and thought, “how on earth did no-one invent that before?” You know the feeling. It’s the one you get while staring numbly at a copy of Harry Potter – all the while wondering how the idea of a boy who goes to school went unwritten for so long. It’s the one people probably had when the first guy rolled by with casters on the bottom of his chair. Even Facebook seems like such a simple idea in hindsight.
Forget happiness or sadness or the feeling of ‘it’s coming home’. It’s this constant ‘so close yet so far’ that’s the prevailing emotion in my life right now. A perpetual reminder that, yes, I’ll never be Mark Zuckerburg, or even a Google elf for that matter. All this is compounded by the fact that, according to my shiny laminated ID card, I’m supposed to be a healthcare design masters student at St Mary’s hospital in London, a building so old it seems to look down enviously at the geriatric ward within. (more…)
On World Health Day, Professor Azeem Majeed takes a look at the past, present and future of the NHS.
In 2018, the United Kingdom’s National Health Service (NHS) celebrates its 70th anniversary. With the creation of the NHS in 1948, universal health coverage was finally implemented in the United Kingdom, with the NHS replacing the previous patchy health coverage schemes that had left many people with limited access to health services. All residents of the United Kingdom were given the right to register with a general practitioner, who was responsible for both providing primary care services and organizing referrals for specialist care. (more…)