Publications by authors named "Nicholas McLeod"

Prostate cancer (PC) is the most common malignancy in men. Internal radiotherapy (brachytherapy) has been used to treat PC successfully for over a century. In particular, there is level-one evidence of the benefits of using brachytherapy to escalate the dose of radiotherapy compared with standard external beam radiotherapy approaches.

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Objectives: The aim of this study is to assess the course and management of poorly differentiated bladder urothelial carcinoma (UC), including plasmacytoid UC (PUC), in our local area. Although bladder cancer is relatively common, PUC is a rare and aggressive subtype with a poor prognosis that is still poorly understood.

Materials And Methods: A retrospective assessment of all poorly differentiated high-grade UC over the last 15 years (2005-2020) in the Hunter New England area was completed.

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Angiomyolipoma (AML) is a benign renal tumour composed of fat, smooth muscle and blood vessels. Radiologic evidence of macroscopic fat within a solid renal lesion on computed tomography was historically thought to be pathognomonic for this condition. Herein, we report a case of an incidental solid renal cell mass with multiple foci of intra-tumoral fat, which was shown to be a clear cell renal cell carcinoma (RCC) at nephrectomy.

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Article Synopsis
  • A case is presented where a solid renal mass with fat was mistaken for AML but turned out to be clear cell renal cell carcinoma (RCC) upon removal.
  • This highlights that just because there’s fat in a kidney lesion doesn’t mean it’s harmless; other imaging features must be assessed when malignancy is suspected.
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Introduction: Stereotactic body radiotherapy (SBRT) is a non-invasive alternative to surgery for the treatment of non-metastatic prostate cancer (PC). The objectives of the Novel Integration of ew prostate radiation schedules with adJuvant Androgen deprivation (NINJA) clinical trial are to compare two emerging SBRT regimens for efficacy with technical substudies focussing on MRI only planning and the use of knowledge-based planning (KBP) to assess radiotherapy plan quality.

Methods And Analysis: Eligible patients must have biopsy-proven unfavourable intermediate or favourable high-risk PC, have an Eastern Collaborative Oncology Group (ECOG) performance status 0-1 and provide written informed consent.

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Objectives: To improve imaging utilisation and reduce the widespread overuse of staging investigations, in the form of computed tomography (CT) and whole-body bone scans for men with newly diagnosed prostate cancer in the Hunter region of NSW, Australia, by implementation of a multifaceted clinician-centred behaviour change programme.

Patients And Methods: Records of all patients with a new diagnosis of prostate cancer were reviewed prior to the intervention (July 2014 to July 2015), and the results of this audit were presented to participating urologists by a clinical champion. Urologists then underwent focused education based on current guidelines.

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Purpose: To explore the prostate-specific membrane antigen (PSMA)-avid distribution of prostate cancer (PC) on positron emission tomography (PET), both at the time of initial diagnosis and at the time of relapse after definitive local treatment.

Methods And Materials: A total of 179 PSMA PET scans in patients with nil or ≤3 lesions on conventional imaging were retrospectively categorized into 3 subgroups: group A, high-risk PC with no prior definitive therapy (n=34); group B, prior prostatectomy (n=75); and group C, prior radiation therapy (n=70). The numbers and locations of the PSMA-avid lesions were mapped.

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Background: Active Surveillance (AS) is recommended for the treatment of localised prostate cancer; however this option may be under-used, at least in part because of expectations of psychological adverse events in those offered or accepting AS.

Objective: (1) Determine the impact on psychological wellbeing when treated with AS (non-comparative studies). (2) Compare AS with active treatments for the impact on psychological wellbeing (comparative studies).

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Background: Overactive bladder syndrome is a symptom-based clinical diagnosis. It is characterised by urinary urgency, frequency and nocturia, with or without urge urinary incontinence. These symptoms can often be managed in the primary care setting.

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Background: Erectile dysfunction (ED) is a common clinical problem managed in the general practice setting. While the majority of men will find phosphodiesterase-5 (PDE-5) inhibitors effective, there is a subgroup of men who require second and third line therapies.

Objective: This article provides an overview of ED and its management with particular focus on the group of patients in whom oral agents fail.

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Background: Bone complications from metastatic disease in prostate cancer have been well documented. Osteoporosis from androgen deprivation therapy (ADT) can further impair quality of life in this already susceptible age group.

Objective: We aimed to assess the intermediate and long term effects of ADT on bone density and the development of osteoporosis in men with prostatic cancer, and outline some practical assessment, management and treatment options.

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We report a case of a massive mediastinal teratoma in an 18-year-old woman who presented with a short history of exertional dyspnoea. The tumor arose from the left lobe of the thymus and extended into the left pleural cavity, completely compressing the left lung and extensively shifting the mediastinum to the right. Measuring 23 cm x 17 cm x 9 cm and weighing 2005 g it is one of the largest anterior mediastinal teratomas reported.

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