Professor Neal is a urological surgeon specialising in prostate cancer. He heads up two groups at the University of Cambridge, one involved in clinical/translational research and one in laboratory research. Professor Neal began his academic life at University College London, where he was initially interested in neuroscience particularly the function of the visual cortex. He went to medical school and soon found he had an aptitude for surgery, he enjoyed that in urology he was able to make a diagnosis and also treat the patient himself. After some time spent in Leeds he was made Chief of Surgery at Newcastle University.
Ten years ago Professor Neal joined the University of Cambridge to build up the clinical department and make Cambridge a centre of excellence for men with urological cancer. He set up a translational research group for men with high risk prostate cancer and a robotic programme with a state of the art da Vinci robot. Using the robot for highly precise prostatectomy surgery, Professor Neal and his team saw a reduced recovery time, with the surgery only requiring an overnight stay as opposed to a week in hospital with traditional surgery. He is extremely passionate that you must link outstanding clinical work with cutting edge research to move treatment forwards.
Many men in older age suffer from prostate cancer but it is so slow growing that they die from other causes before it becomes a problem. Professor Neal and his team aim to understand why 40,000 men a year however, suffer from very aggressive prostate cancer, a quarter of which die from it. They are looking in to how the interaction of testosterone with the androgen receptor regulates prostate cell growth and therefore causes cancer. Professor Neal has been looking at how the androgen receptor regulates pathways of metabolism and DNA repair both of which have significant roles in cancer development. He would like to improve the cure rate from surgery which currently remains the best curative treatment we have for cancer. He believes this can be done by offering surgery in conjunction with drugs; there are several promising drug candidates currently in clinical trials for prostate cancer.
Currently, diagnosis of prostate cancer is via a blood test called the PSA test which measures the concentration of prostate specific antigen in the blood. But this test can give false negatives and some men have a raised PSA but do not have prostate cancer. Professor Neal’s team aim to identify new biomarkers which can be used to test for genetic mutations or abnormalities in blood and urine. This would give more accurate results than the PSA test and will help group patients, reducing surgery for those where it is not necessary. Cancer research UK have also funded the team to carry out genetic profiling, sequencing DNA in blood samples to test for a genetic pre-disposition to prostate cancer.
As for the future of his field, Professor Neal believes we should exploit the application of physics to medicine, particularly with respect to intraoperative imaging. The prostate is buried very deep in the pelvis and is surrounded by nerves which preserve sexual function and urinary continence, the more precise imaging is, the more accurate and successful surgery can be. He feels Cambridge excels in its links to pharmaceutical companies and is particularly excited at the move of the global headquarters of AstraZeneca to Cambridge, a company with strong research in the cancer field.
While Professor Neal is pleased to receive recognition for his years of hard work dedicated to the improvement of diagnosis and treatment of prostate cancer, he is also very thankful to all the people he has worked with from Newcastle to Cambridge over the years.
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