BAUS 2020: Reasons For Men To Be Cheerful

Baus 2020 This week was the annual meeting of BAUS, the British Association of Urological Surgeons. Like most meetings this year, it was held everywhere and nowhere – eg online. But that didn’t detract from the presentation of and discussion around multiple innovations that will have real impact on men with prostate cancer.

Medical conferences like this are an important way for clinical, research, academic, and medical industry (eg drug, device & supply) people to learn and share, both formally and informally. They contribute to the adoption of new technologies and techniques, the shifting of attitudes, and, ultimately, improvements in patient care.

Two presentations stood out in their focus on how technology is being used to improve both the performance of clinicians and the outcomes for prostate cancer patients.

In a session on the evolution of minimally invasive surgery in UK Urology, Prof Prokar Dasgupta of Kings College London spoke on how advances in digital technology and Artificial Intelligence are helping surgeons to improve their surgical performance, and to increase precision in prostate surgery.
In terms of performance, Prof Gupta has been using AI to analyse videos of surgical procedures, resulting in metrics to improve surgeons’ performance, such as accuracy, consistency and efficiency.

3D printed modelsHe also demonstrated how he’s using AI to “volumise” images on a prostate MRI scan and create 3D printed models of individual prostates, which are then used for surgical improvement. The photo below shows a 3D model of a prostate with tumour, and the actual prostate which had been surgically removed with a significantly improved level of precision.

Professor Hashim Ahmed of Imperial College presented his view on the future of Urological Cancer Management, which he described as “rosy”. Prof Ahmed is one of the world’s leading innovators in the development of imaging-led diagnostics for prostate cancer and minimally invasive treatments like focal therapy.

He predicted some big advances in screening, early diagnosis and minimally invasive therapies for prostate cancer over the next ten years, starting with the sobering context of an increasing health burden – 60-65k men per annum will be diagnosed with prostate cancer by 2030.

MRI scans and biopsiesAs his graph shows, diagnoses are growing but so are the required MRI scans and biopsies, and at a faster rate, making the clinical burden fall largely on radiology and pathology. Expertise in these areas is already experiencing shortages and expected to continue, increasing the possibility of diagnostic errors and inappropriate treatments. Prof Ahmed believes that AI and machine learning will play a role in addressing this problem, and sees evidence of this already.

He described how AI tools will help in screening, diagnostic imaging and histopathology, and showed how in some cases, particularly histopathology, AI tools are already bettering the performance of humans in “seeing” significant cancers.

In terms of minimally invasive therapies, Prof Ahmed pointed to a prediction from an American colleague, who suggested that “if the past 25 years brought minimally invasive procedures, the next 25 will see the elimination of invasion”. This may not be entirely accurate on the outcome but it certainly describes the direction of travel, as Prof Ahmed confirmed that “Focal Therapy is now coming into its own with more data on recurrence and mortality, all looking very favourable and improving all the time.”

With the commitment to improving the outcomes for men with prostate cancer shown this week at BAUS, there is reason for men to be optimistic. Cheerful, even. And we can all certainly use a bit of that.

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