Parkinson's drug could treat depression following promising Oxford trial
He saw an improvement in just a few weeks and three years later the 72-year-old is still reaping the benefits."Oh it's fantastic, I'm enjoying life again. When I think I've missed 20 years of enjoyment, I'm making up for it now.
"I got myself a motorbike, I go out on once a week. I try and play a guitar, I've built a couple from kits, I love cooking. It's all come back."
For two decades Phil suffered with depression. He says he tried every kind of treatment going but nothing worked."I was in a very dark place. If I got up in the mornings it was a bonus. If I got up and went downstairs I sat in a chair and was just nowhere.
"I had no motivation, no interests, I lost interest in doing all the hobbies and things like that. Nothing, nothing at all would pull me out of it."But that all changed when he was invited to take part in a drug trial for treatment-resistant depression.
He was given Pramipexole, which is traditionally used to treat Parkinson's Disease. It boosts dopamine which affects our experience of enjoyment."There was less tiredness, more motivation, less feeling emotional.
"I mean, you get very emotional when you're depressed, believe me, because you sit there sometimes with tears streaming down your face for no reason.
"And all that started to pick up. Probably within about six to eight weeks I was living a reasonably normal lifestyle again."The idea of trialling the drug came from Professor of psychiatry at the University of Oxford, Michael Browning.The research involved 150 patients. Over the course of a year, half were given Pramipexole and half a placebo.The drug was discovered to be about twice as effective as other treatments.
Professor Browning said: "I run a clinic for people with difficult to treat depression, also that's the only sort of patient that I see.
"I have to say, I used this drug for a bit and it isn't subtle how effective this drug is.
"Compared with the other treatments I use it's obviously a lot better, so I wasn't surprised at how effective it was in this study.
"I was worried that maybe I hadn't done the study well enough to measure it so I was quite relieved to see the study was so positive.
"But this chimes with my clinical experience. This is what I see when I use this drug to treat patients. It is really an effective treatment."
"It's given me my life back," said Mr Harvey, "That's the sheer simple factor, it's given me a life back again which I hadn't got."However, Pramipexole can cause side-effects. Once more research is done to reduce these, it's hoped prescriptions could be made available from from GPs.
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Telegraph
14 hours ago
- Telegraph
The PSA test for prostate cancer – everything you need to know
Prostate cancer is the most common form of cancer among men in England, with cases surging among both men and women by 25 per cent between 2019 and 2023 according to NHS data. It's also the second deadliest form of the disease for men after lung cancer, killing one man every 45 minutes despite being highly curable if caught in time. Yet there is still no formal screening programme for prostate cancer in the UK. In the US, Czech Republic and Lithuania by contrast, screening is offered to men within a certain age bracket via a simple blood test, the PSA test. 'We know that in countries with formal PSA screening programs, the rates of advanced prostate cancer are a lot less,' says Prasanna Sooriakumaran, a professor of urology at the University of Oxford, and a consultant urologist at University College London Hospitals. 'In this country, one in five men with prostate cancer present at an advanced, incurable state whereas in the US, that number is significantly under 10 per cent and that's because of PSA screening.' So what is this test and what does it tell you? What is a PSA test? As David James, the director of Prostate Cancer Research, explains, the PSA test measures the levels of a prostate-specific antigen, a protein made by cells within the prostate. Because cancerous cells can enable PSA to slip more easily out of the prostate and ultimately reach the bloodstream, it can serve as a biological signal for the presence of a tumour. 'High levels don't always mean cancer, but they can be an early warning sign and usually lead to further tests to find out if cancer is present,' says James. 'It's one of the best tools we have right now to help catch prostate cancer early, often before any symptoms appear.' Who can have a PSA blood test? While PSA testing is not routinely available on the NHS, all men aged 50 or over can, in theory, request an appointment with their GP to discuss the possibility of getting a test. Black men over 45 who are at higher risk of prostate cancer because of their ethnicity are strongly recommended to discuss having a PSA test with a doctor, as well as all over-45s with a known family history of the disease. Clément Orczyk, a consultant urological surgeon at University College London Hospitals says that PSA testing is also highly recommended for men who have blood in their urine, problems getting an erection or have begun peeing more than usual, although he urges men not to panic if they are having any of these symptoms. 'Most of the time it's linked to benign prostatic hyperplasia, the normal age-related enlargement of the prostate, not cancer,' he says. What happens during the test? Emma Craske, a specialist nurse for Prostate Cancer UK, explains that the PSA test is taken like any other blood test. While some men are reluctant to come forward for testing because they are worried that it will lead to a digital rectal examination (DRE), she says this is unlikely to happen. Instead, an abnormal reading would lead to an MRI scan being booked at the hospital. 'The MRI scan is far more accurate at identifying abnormalities within the prostate than a DRE,' she says. How do I request a PSA test? Orczyk says that you simply have to book a GP appointment and request one. 'But before asking for a test, it's important to be prepared for the potential consequences of having the test,' he says. 'For example, the fact that you might then need to be referred for further screening, and because the test isn't necessarily specific to cancer, people can be sometimes falsely reassured or falsely alarmed by their results.' Why would I be refused a test? The most obvious reason is because you are not considered eligible, for example under 50 and with no standard risk factors. When such instances happen with men who should be eligible for a test, Sooriakumaran suggests that it may be because the GP is worried about their capability of interpreting a borderline result. 'If the result is grossly abnormal, it's easy for the GP, they send them on to a specialist, and if the result is normal, it's also easy for the GP,' he says. 'But it's that grey area which causes concern.' What can I do if my GP refuses a PSA test? There are an increasing number of high-street providers which offer low cost PSA tests, but Orczyk advises people to steer clear of them, as getting an accurate result requires the use of medically certified laboratories, such as those used by the NHS. Instead, Sooriakumaran recommends pushing back, emphasising your concerns and explaining why you wish to have a test. 'I don't know many GPs these days that would point blank refuse if they were getting pushback,' he says. 'Tell them that specialists would much rather see men who got early curable prostate cancer, then men presenting much later with advanced cancer.' Is there anything I can't do before the test? According to Craske, anal sex and any form of prostate stimulation are out of bounds for a week before the test, while in the 48 hours prior to testing, men should also abstain from vigorous exercise and ejaculation. If you have recently had a urine infection, bladder or prostate surgery, she says it is advised to wait six weeks before having the test. 'You can eat and drink as normal before a PSA test, including alcohol,' says Craske. 'There are a group of medicines used to treat benign enlargement of the prostate that may artificially reduce the PSA level, known as 5-alpha-reductase inhibitors such as finasteride or dutasteride. Patients on these drugs need to have this taken into account when doctors interpret the results.' How long will the results take? Craske says that results usually come back within a week, and can be obtained either via the NHS App or by calling the surgery. She advises asking for the exact figure, even if the result is normal. 'This can be helpful if you choose to have a PSA test in the future, to recognise a trend,' she says. What is a high PSA and what does it mean? Interpreting the PSA test can be complex, according to Sooriakumaran, as the results come with considerable individual variability. There are age-specific reference ranges for PSA because the prostate naturally enlarges and produces more of this protein as we get older. For example, if you are aged between 40-49, a PSA reading of more than 2.5ng/ml may be considered high, while if you are over 70, it would have to be more than 6.5 ng/ml. But exceeding these thresholds does not automatically imply cancer. Craske explains that there can be other factors such as a recent urinary tract infection which elevate your PSA levels, while some men simply have a larger prostate than average, meaning that their 'normal' level is higher than others. Because of this, statistics show that only one in four men that have a high PSA are at risk of having prostate cancer. What is a normal PSA result? Sooriakumaran says this would be a prostate-specific antigen reading which is within the expected range for your age group. So, for example, for men aged 50-59, this would be below 3.5ng/ml. However again, a 'normal' value can differ from one man to another. 'What really matters is how the PSA changes with time,' says Sooriakumaran. 'Because there's no such thing really as a normal PSA or an abnormal PSA. It's all about how it is for your size of prostate.' I have a normal PSA result. When should I check again? Repeat testing tends to be recommended for men who have an increased risk of prostate cancer due to ethnicity or family history. Some healthcare providers, such as Johns Hopkins Medicine in the US, suggest getting PSA testing done every two to four years to see whether there is any change in the trend, but if your values are low and you have no known risk factors, the NHS may not offer repeat tests. 'If the PSA is completely bang normal, or in the low range, the PSA may not be repeated,' says Sooriakumaran. 'But if you have risk factors, it's up to the GP to decide whether they want to repeat the test one or potentially three years later.' I have a high PSA result. What happens next? If you have a family history of the disease, or you are of black or Ashkenazi Jewish ethnicity meaning that you are of heightened risk, or your PSA levels are particularly high, then your GP will have a discussion about referring you to a specialist for further testing. While some urology specialists may suggest a rectal examination, Sooriakumaran says that more expert urologists will not because it is not a very sensitive or accurate test for prostate cancer. Instead the standard NHS pathway, as recommended by Nice guidelines following a high PSA reading, is a referral for an MRI of the prostate. What further tests can I expect? In some cases, a urine test may be offered to rule out infection as a possible cause of raised PSA levels. But the standard procedure is to then book an MRI of the prostate, followed by a prostate biopsy. Biopsy technology has evolved considerably. Some NHS Trusts still carry out a transrectal prostate biopsy, where an ultrasound probe is inserted through the rectum and used to collect tissue samples from the prostate. However Sooriakumaran says that a newer technology, known as a transperineal biopsy – where a thin biopsy needle is inserted through the layer of perineal skin between the testicles and anus – is becoming more common as it is more accurate and carries a lower risk of infection. 'Over the next year or two, there will be fewer and fewer NHS Trusts that do a transrectal biopsy, and more will move to this newer method,' he says. On the NHS, Sooriakumaran says that the standard timeframe for the results to become available is two to four weeks following the procedure. In the private sector, results will be available between three and seven days. I have a high PSA result, but my GP won't refer me for further tests. What can I do? This could be because while your PSA reading may be outside the expected range for your age, it is still considered only slightly abnormal. In such cases, Sooriakumaran says, it may be standard for a GP to repeat the result a few weeks later, before referring you for further testing. If considered borderline, you may be offered a repeat PSA test six months or a year later, to help assess whether such a result is normal for you or not. How accurate is the test? While the PSA test plays an important role in ensuring that more men are put forward for detailed examinations, the test itself is not especially accurate. According to Cancer Research UK, the major issue is so-called 'false positives' with 75 per cent of men with a high PSA value, not actually having prostate cancer. But there are also 'false negatives' with 15 per cent of men with a normal PSA value actually having the disease. 'This is where the value of the test is greatest when there's repeat measurement over time, so you can see if there's been a change,' says Sooriakumaran. What other factors can raise your PSA levels? As well as age and urinary tract infections, there are a range of factors which can increase your PSA levels in the short term, from inflammation of the prostate, or simply because you have recently been cycling or horse riding. In the latter case, the pressure and movement of the pelvic muscles against the prostate leads to increased blood flow and the release of more PSA into the bloodstream. Even ejaculating or having had sex during the past 48 hours can increase your PSA levels. What are the downsides of the test? One of the major risks is that men with a high PSA test reading have then been referred for an invasive biopsy, which can cause an infection, leading to sepsis. In addition, many men have so-called 'clinically insignificant' prostate cancers, which means that they are very unlikely ever to spread, and so do not require treatment. According to Prostate Cancer UK, new technologies such as next generation multiparametric MRI scans, which are becoming more common, can help to prevent unnecessary biopsies. In addition, newer transperineal prostate biopsies are more accurate at separating the problematic from insignificant cancers, and reducing risk of sepsis. What happens if I'm diagnosed with prostate cancer? You will be referred to a specialist oncologist to discuss the next steps. There are many different paths which can be followed, depending on your circumstances and wishes. If the cancer has not spread beyond the prostate, there are various curative options available ranging from surgery and radiotherapy, to minimally invasive treatments such as so-called focal therapy which involves zapping the tumour with high intensity ultrasound or freezing it. Sooriakumaran says that the biopsy will also reveal whether the cancer is aggressive or low risk. For patients in the latter category, your oncologist may recommend surveillance, especially if they have other conditions like heart disease which pose a greater threat to their life, because the risk of the tumour spreading is low. 'If it has gone outside the prostate, they typically will be offered hormone therapy,' he says. 'If it's just outside the prostate, then they will have radiotherapy as well, and occasionally they might have surgery as well, depending upon how much disease there is outside the prostate.' What are the different treatment options if I have prostate cancer? The good news for men who are diagnosed with prostate cancer is that the range of available treatment options is increasingly broad. Sooriakumaran says that patients have a huge amount of say in what treatment they end up getting, with various advantages and disadvantages to each therapy. Here are some of the options: Focal therapy Therapies such as ultrasound and cryotherapy tend to hold the cancer at bay for a few years rather than curing it, but they have far fewer side effects than other treatment options. Surgery This has the advantage of being a one-off procedure, but cutting a tumour out of the prostate does carry the risk of driving erectile dysfunction or urinary incontinence. Radiotherapy This is a better option for preserving erections, but has more side effects on bowel function, while it tends to involve regular hospital visits across the duration of the treatment course. Hormone therapy Newer hormonal therapies such as abiraterone are only offered for people with metastatic disease which has spread beyond the prostate. They have made a major difference when it comes to slowing down cancer progression and enabling people to live with incurable prostate cancer for much longer, but carry side effects such as hot flushes, reduced libido, weight gain and fatigue. 'It's often up to the patient to decide because some men would rather preserve their erections at all costs, and therefore may not want surgery, while some men don't want to have to come to hospital every day for six weeks,' says Sooriakumaran. 'So it's very much a personal choice, once the specialist has gone through the treatment options.
BBC News
2 days ago
- BBC News
Uranus: Giant ice planet could be warmer than first thought
The planet Uranus is known for being one of two ice giants in the outer solar system and sits in a remote part of the Milky one Nasa spacecraft, Voyager 2, has ever travelled close to it and the planet has long been thought of as a cold and distant could it actually be warmer than we first thought?A new study by scientists suggests that could be true as they think Uranus gives out more heat than it receives from the Sun. What did scientists find? The new study was carried out by a group of experts from Nasa and from the University of Oxford in the decided to take a closer look at the huge planet, which is four times wider than of the reasons scientists don't know much about Uranus is because it's located so far only ever been visited once before, in a brief flyby by the Voyager-2 probe nearly 40 years ago, in from that mission suggested the planet is colder than expected, which challenged ideas of how planets formed and the team decided to use the latest tech and advanced computer modelling and take a fresh new look at the old a result, scientists now think the planet may actually be warmer than previously author Professor Patrick Irwin, from the University of Oxford, explained: "We did many calculations to see how much sunshine is reflected by Uranus and we realized that it is actually more reflective than people had estimated."Researchers found that Uranus releases about 15% more energy than it receives from the Sun, suggesting that it has its own team says that the discovery could help people better understand exoplanets, which are planets located outside the solar system. Five top facts about Uranus 1. Uranus is the seventh planet from the Sun, and the third largest planet in the Milky Way.2. Uranus is unlike any other planet in our solar system. It spins on its side, which means each pole directly faces the Sun for around 42 years at a time, followed by 42 years of complete darkness.3. Uranus has two sets of rings. The inner group of nine rings is mostly made up of narrow, dark grey rings. There are also two outer rings: the innermost one is reddish in colour, and the outer ring is blue.4. Uranus is one of just two planets in our solar system that rotate in the opposite direction to all the rest of the planets in the Milky Way - the other one being Venus.5. According to Nasa, Uranus gets its blue-green colour thanks to methane gas in the atmosphere. Sunlight passes through the atmosphere and is reflected back out by Uranus' cloud tops. Methane gas absorbs the red portion of the light, resulting in a blue-green colour.
BBC News
3 days ago
- BBC News
Inspectors finds Colchester care home residents at risk of harm
A care home for older people has been placed in special measures after inspectors found residents were at risk of were 21 people using Quenby Rest Home in Colchester, Essex, when an inspection took place between 20 March and 1 Care Quality Commission (CQC) rated the service inadequate as it was unclean, staff lacked training and some people were at risk of the service has been placed in special measures, while improvements take place the CQC says it will review the service to ensure people living in the home are safe. This inspection was prompted after an incident related to people's safety. That is now being further investigated by the CQC and was not part of this report explained: "The information shared with CQC about the incident indicated potential concerns about the management of risk of choking for others living at the service. This inspection examined those areas." The report criticised the service for not having a system in place to help people with swallowing difficulties when eating food or drinking mentioned staff had not been encouraged to learn or reflect on safety events, such as a recent choking incident, to prevent similar occurrences happening also found other risks to safety had not been identified or managed to prevent potential of staff were found to lack training, with some not being able to demonstrate an understanding of the training they had training had been done on computers with some inequalities found in staff guidelines had not been followed and there was no system in place to manage medicines it came to prescribing sedatives, the report said: "Protocols did not contain guidance for staff on what interventions should be tried before administering the medicine, as a last resort."It continued: "People living with specific health conditions, such as Parkinson's, diabetes, and epilepsy did not have detailed care and support plans in place to ensure staff knew how to monitor and meet their needs safely. "For people living with dementia, staff had not received specialist training to ensure they understood changes in the person's levels of understanding and had the required skills to support the person to continue to achieve their full potential." 'Poorly maintained' The environment at the home was described in the report as "tired" and "poorly maintained".A cleaning cupboard was not itself clean, a sink had missing or cracked tiles above and the "small and cluttered" laundry room had water damage on the ceiling with an incomplete a toilet had been removed the waste pipe hole had been poorly filled, leaving a large gap in the lino that was not flush with the rest of the report said: "Incomplete flooring and missing tiles can create a breeding ground for bacteria and other microorganisms, potentially leading to increased risk of infection."The home had previously been told on 13 March, following an audit by the Integrated Care Board, to improve infection control but CQC inspectors found no plan had been created when they arrived a week provider has been contacted for comment. Follow Essex news on BBC Sounds, Facebook, Instagram and X.
