Fitzpatrick, John Michael (1948–2014), urologist and surgeon, was born on 15 July 1948 in Dublin, the eldest of three sons of Hugh Fitzpatrick, a solicitor, and his wife Mary (née Shinkwin). The family lived on Ailesbury Road, Ballsbridge, Dublin, and later Merrion Road, and Fitzpatrick was educated at Gonzaga Preparatory School (1955–9) and Gonzaga College (1959–65) in Ranelagh. At Gonzaga he excelled at languages, enjoyed history and literature, and revelled in the debating culture fostered by the Jesuits. He left school in 1965 intending to study ‘Greats’ at Oxford University and travelled to Syria, Jordan and Egypt with a friend, but at the last minute enrolled to study medicine in UCD. In 1971 he graduated MB, B.Ch. and BAO (winning the Magennis medal in clinical surgery) and completed his internship in St Vincent’s and Sir Patrick Dun’s hospitals in Dublin. Patrick Fitzgerald, the head of surgery at the former, instilled in him an appreciation of the way in which scientific research could help refine existing surgical techniques as well as an interest in developing novel approaches. In gaining the fellowship (1975) of the RCSI and a M.Ch. (1976) from UCD, Fitzpatrick was drawn to urology, in which he soon gained surgical experience at St Vincent’s.
With inadequate training opportunities available in Ireland, he moved in late 1977 to the Institute of Urology and the St Peter’s hospitals in London. There, as registrar and later senior registrar, he gained experience in andrology (physiology and medicine specific to men) and urodynamics (bladder pressure). Already an experienced surgeon, he learnt novel surgical techniques from John Wickham, a pioneer of minimally invasive surgery. Wickham arranged for him to undertake four months training in Mainz, Germany, under Rudi Hohenfellner, which introduced him to leading urological surgical practice and further spurred his interest in research. In both cities he formed professional friendships which assisted his future career.
Fitzpatrick returned to Dublin in 1981 as a senior lecturer in urology at TCD and consultant urologist to the Meath and St James’s hospitals. He maintained a significant surgical workload while, somewhat unusually, also undertaking laboratory-based research. In 1986 Fitzpatrick – ahead of seven other candidates, all general surgeons – was appointed professor of surgery at UCD and consultant urologist at the Mater Hospital, Dublin. Not without some institutional and bureaucratic conflict, he then established a laboratory dedicated to the science of urology and significantly expanded urology services at the Mater. He was among the earliest advocates of prostate specific antigen (PSA) testing to detect prostate cancer. However, as the limitations of that approach were established by further research, he championed the diagnostic precision of digital examination. The second most common cause of death in men, and the most common form of male cancer, prostate cancer was frequently diagnosed late. Fitzpatrick campaigned with the Irish Cancer Society (ICS) for improved screening programmes to enable earlier diagnosis and thus more effective treatment.
From the 1970s onwards he worked with Zeneca and other pharmaceutical companies to develop drugs to inhibit testosterone production (on which advanced prostate cancer was dependent) and to impede testosterone receptors, both approaches negating the need for surgical castration. When cancer was found to be confined to the gland and at an advanced stage, Fitzpatrick promoted the total surgical removal of the prostate. An early practitioner of keyhole surgery, he developed a skill and versatility that allowed him to transition to robotic surgery as that approach matured. After 2000 he was deeply involved in the development of novel pharmaceutical treatments targeting advanced prostate cancer. He led the way in refining complex diagnostic and treatment strategies which relied on robust biomarkers, precision surgical techniques and tailored oncology regimes – work that did much to extend the life of those with recurring disease.
In 1994, with Bob Campbell and Bill Hendey, Fitzpatrick co-founded the Urology Foundation (TUF), a charity supporting urological research and training in Ireland and the UK, and became a trustee and patron. Well-connected in international urological research, he was editor of the British Journal of Urology International (2002–12), in which he promoted the use of magnetic resonance imaging to improve targeting of cancer treatments and minimise the use invasive biopsies. He was on the editorial board of twenty-five other medical and scientific journals. His extensive research interests included reconstructive urology, infertility and erectile dysfunction.
At UCD he directed the Prostate Cancer Research Consortium, a collaboration with DCU, the RCSI and TCD (and their affiliated teaching hospitals), which pursued novel multi-disciplinary research into drug treatments and surgical approaches. This informed Fitzpatrick’s appointment as the ICS’s first head of research after his retirement from the Mater and UCD in 2011. He focused on developing collaborative research in response to the often fragmented and poorly funded nature of existing efforts in Ireland. With support from Science Foundation Ireland, he was integral to the establishment of the Collaborative Cancer Research Centre, informed by the approach he had developed while at UCD. He garnered funding and institutional support for this multi-disciplinary project, engaging with epidemiologists and health economists, among others, to identify cost-effective and efficacious approaches to cancer treatment. Championing the importance of patient outcomes, Fitzpatrick emphasised the need to improve their quality of life rather than just extending their lifespans. He was especially concerned with the care afforded to geriatric cancer patients, who he argued should be afforded the same care as younger patients.
In July 2013 Fitzpatrick spearheaded the ICS’s partnership with the charity Movember to found the Prostate Cancer Outcomes Research project. A clinical registry, the project sought to measure and assess the diagnosis and treatment paths experienced by prostate cancer patients in Ireland. It built upon existing cooperation with TCD’s Donal Hollywood (qv), among others, and sought to identify predictive biomarkers of disease, drawing on Fitzpatrick’s earlier research into bladder cancer. In August he was instrumental in establishing BREAST-PREDICT, which pooled funding, research facilities and expertise to understand better the causes and progression of breast cancer in women. Fitzpatrick was integral to these ICS-led Collaborative Cancer Research Centre projects, regarded as significant milestones in Irish oncology.
Gregarious, sociable and keenly interested in people, Fitzpatrick revelled in the extensive travel demanded by his international research collaborations and gruelling schedule of conferences and colloquia. He was a visiting professor to numerous prestigious medical and research institutions around the world and tirelessly fundraised for TUF and other charities. Regarded by his peers as one of the world’s foremost urologists, he published over 280 peer-reviewed articles, composed over 100 book chapters and edited 18 medical and surgical textbooks. His many honours included the American Association of Genitourinary Surgeons Spence medal (2010) and the Sociéte Internationale d’Urologie distinguished career award (2012). A president of the Irish Society of Urology and the first Irish president of the British Association of Urological Surgeons, he was awarded their St Peter’s medal in 2004. He was awarded the T. J. D. Lane medal for urology from TCD and the Millin (1983) and Abraham Colles (1987) medals from the RSCI. He was also a fellow (1998) of the RCS (London), and an honorary fellow of the Royal College of Physicians and Surgeons of Glasgow and of over fifteen other national urological societies.
His interests included fine wines, history, literature, classical music and travel. He undertook many treks and hikes in remote regions with friends and colleagues, often fundraising for research projects. On 9 February 1974 he married Dr Carol O’Donoghue, who was later professor of child psychiatry at UCD; they had a daughter and two sons together and lived on Brighton Road, Foxrock, Dublin. Taken ill while exercising in his home gym, he died on 14 May 2014 of a brain haemorrhage at Beaumont Hospital, Dublin. After a funeral mass at the Our Lady of Perpetual Succour church, Foxrock, he was cremated at Mount Jerome, Dublin. In his memory the Irish Association for Cancer Research annually presents the John Fitzpatrick award to a promising early career researcher, while the ICS awards the Professor John Fitzpatrick research fellowship; a John Fitzpatrick genitourinary cancer conference is held annually in Ireland.