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With a father and aunt who were GPs and an uncle a chest physician in Edinburgh, it was almost inevitable that Peter George Herbert Summers would pursue a medical career. After surgical training in Plymouth, Liverpool, and London …

OBJECTIVES: To present our experience with the long-term preventive effect of immunotherapy with Uro-Vaxom® on recurrent urinary tract infections (UTI) in adult patients. MATERIALS AND METHODS: Retrospective analysis of 79 patients with recurrent UTI treated with Uro-Vaxom. Recurrent UTIs were defined as ≥ 2 infections in 6 months or ≥ 3 in 12 months. Patients received a 6 mg Uro-Vaxom capsule daily for 90 days followed by discontinuation for 3 months and then administration for the first 10 days of subsequent months 7, 8 and 9 as a ‘booster’ regime. The primary outcome measure was the number of UTIs encountered in the 12 months pre-treatment compared to 12 months post-treatment. RESULTS: There was a significant decrease in the mean number of UTIs in the year following initiation of Uro-Vaxom® compared to the year preceding administration 3.14 versus 1.53 (p < 0.05) respectively. CONCLUSION: Uro-Vaxom represents a safe and effective treatment option for prophylaxis of recurrent UTIs. In the UK, Uro-Vaxom is currently unlicensed. This study adds to a growing body of evidence in favor of non-antibiotic immune-prophylaxis for recurrent UTI.

Four urologists relate their personal experiences of prostate cancer and highlight some important learning points. Copyright © 2013 John Wiley & Sons

Renal cell carcinoma rarely presents with typical features of abdominal pain, flank mass and haematuria, and up to 30% of patients present with metastases. We present the case of an 81 year old man who presented with a painless, pulsatile sternal metastasis as an initial presentation of renal cell carcinoma. This case highlights the importance of recognizing even unusual presentations of renal cell carcinoma, and that although sternal metastases are rare, when they do occur there should be a low threshold for ruling out renal cell carcinoma.-------------------------------Cite this article as: Hoyland K, Vasdev N, Nathan P, Hanbury D. Painless pulsatile mass as first presentation of renal cell carcinoma. Int J Cancer Ther Oncol 2014; 2(3):02036. DOI: 10.14319/ijcto.0203.6

Objective: To investigate non-invasive detection of cancer by testing for unusual CD44 gene activity in a clinical sample as an indicator of exfoliated tumour cells. Design: Case-control study. Subjects: 44 unselected, consecutive patients with bladder cancer and 46 people with no evidence of neoplasia. Main outcome measure: Presence or absence of large CD44 gene products containing exon 6 derivatives in urine samples. Results: Novel abnormalities in the pattern of expression of this gene, seen specifically in tumour tissue, led to cloning of a newly recognised coding region in it (exon 6). This was tested as a probe for detection of exfoliated malignant cells in naturally voided urine. CD44 gene products extracted from the urine and amplified with polymerase chain reaction contained predicted electrophoretic band of 735 base pairs in 40 of the 44 patients with bladder cancer (sensitivity 91%). Products from 38 of the 46 people with no evidence of neoplasia showed no such band (specificity 83%). Conclusions: Unusual activity of the CD44 locus in neoplasia and malignancy is confirmed, and techniques for the analysis of such activity can enable non-invasive investigation of patients for primary or recurrent bladder cancer or for other tumours that shed neoplastic cells into body fluids.