Urologist who played a leading role in improving the treatment of men suffering from prostate cancer
Published 03/08/2014 | 02:30
Professor John Fitzpatrick, who has died aged 65, was among the world's most eminent urologists, and one of the leading lights in the transformation in the care of men suffering from prostate cancer.
Fitzpatrick was one of the earliest advocates of the use of prostate specific antigen (PSA) as a means of early detection of the disease. More recently, in his capacity as editor-in-chief of the British Journal of Urology International (BJUI), he had helped to promote the use of magnetic resonance imaging (MRI) in advance of prostate biopsy to facilitate the targeting of the cancer and to reduce unnecessary biopsies.
During the 1960s and 1970s, following the discovery that advanced prostate cancer is dependent on the male hormone testosterone, many men with advanced prostate cancer were treated by surgical castration. The discovery of goserelin acetate in Zeneca's laboratories in Manchester transformed the situation, allowing for non-surgical castration by means of injection. After pioneering this new approach, Fitzpatrick helped the same company to develop and popularise the use of the anti-androgen bicalutamide, a medication in tablet form which blocks the testosterone receptor, rendering the cancer quiescent.
Fitzpatrick, who practised in Dublin, was among the first in Britain and Ireland to embrace total surgical removal of the prostate as a way of eradicating prostate cancer at a stage when it was still confined to the gland and had not spread to the lymph nodes or bones. Adopting the nerve-sparing technique developed by Patrick Walsh at Johns Hopkins University in Baltimore, Fitzpatrick cured many men of their prostate cancer while successfully preserving their sexual function.
Following the introduction of the da Vinci surgical robot, which permits a keyhole approach , Fitzpatrick succeeded in making the difficult transition from open to keyhole surgery. It is a measure of the man that he was able to master this radically new technology at a relatively late stage of his career.
Over the last decade Fitzpatrick had been intimately involved in two other highly significant developments in the field of prostate cancer: the use of taxane-based chemotherapy for men whose cancer had spread, but were no longer responding to first-line hormonal therapy; and the development of two new second-line medical treatments - abiraterone and enzalutamide, both of which have been shown to extend the lives of men whose cancer has relapsed after initial hormone therapy, with only modest side effects.
The son of a prominent Dublin lawyer, John Michael Fitzpatrick was born on July 15, 1948 and educated at Gonzaga College. Having won a scholarship to read Greats at Oxford, he qualified in Medicine from University College Dublin in 1971. Before going up to UCD, however, he demonstrated a taste for adventure by travelling with a teenage friend through Syria, Jordan and Egypt; later, still only 19, he visited communist-era Czechoslovakia just before the Prague Spring of 1968.
His training included a spell in London, where he worked with, among others, the surgeon John Wickham. Returning to Dublin as a consultant in 1986, aged 38, Fitzpatrick was appointed Professor of Surgery at UCD, where he soon established a clinical and research centre of excellence.
In 1994, alongside Bill Hendry and Bob Campbell, he set up The Urology Foundation (TUF), which supports training and research , negotiating £250,000 grants from the British Association of Urological Surgeons (BAUS) and the BJUI. He served as chairman of TUF's scientific committee. To raise funds for TUF, he embarked with the urologist Professor Roger Kirby on a series of expeditions: climbing Mounts Kilimanjaro and Kinabalu; trekking in Nepal; and cycling in Sicily, Malawi and Madagascar.
He served as president of BAUS, and was a visiting professor in nearly 100 academic institutions in North America. He served as director of research at the Irish Cancer Society after retiring from UCD in 2011. He was very closely involved in the development of the €7.5m Collaborative Cancer Research Centre developed by the Irish Cancer Society and Science Foundation Ireland (SFI) and industry to bring researchers together to tackle cancer head on, using a multi-disciplinary approach.
Fitzpatrick loved travelling, always occupying seat 2A in the British Airways first-class cabin. He drove a Bentley, and was a connoisseur of wines. A voracious reader, his principal intellectual interest was military history, particularly World Wars I and II and Wellington's Peninsular War campaign.
John Fitzpatrick was taken ill at home in his own gym; he died from a massive subarachnoid haemorrhage.
Professor John Fitzpatrick, who died on May 14, is survived by his wife, Carol (nee O'Donohue), Emeritus Professor of Child Psychiatry at UCD, and by their daughter and two sons.