We're joining forces on a £3.2m trial to revolutionise hormone therapy for thousands of men

We're coming together with Cancer Research UK to fund a £3.2 million clinical trial that aims to help men with advanced prostate cancer by reducing the side effects of hormone therapy. 

Men diagnosed with advanced prostate cancer – where the disease has already spread – are typically offered powerful hormone therapies. While these can extend life, side effects such as fatigue, hot flushes, and high blood pressure can be so severe that some men struggle to stay on treatment. 

The ENHANCE trial aims to find a better way. 

It will test whether lower doses of commonly used hormone drugs are as effective as standard doses - while being far easier for men to live with. 

The ENHANCE trial will focus on the drugs abiraterone, enzalutamide, darolutamide and apalutamide, comparing full dose with half dose treatment. If successful, it could influence prostate cancer treatment guidelines in the UK and internationally, improving care for thousands of men and reducing costs for the NHS.  

The trial will also collect blood, urine and cancer cell samples from the men taking part, to see whether it’s possible to develop a test to pick out which men are most suitable for a reduced-dose treatment, shaping more personalised care in the future. 

Recent advances mean more men are living longer with advanced prostate cancer. Following our campaigning, and evidence from the Cancer Research UK–funded STAMPEDE trial, drugs such as abiraterone are now offered earlier in England. ENHANCE builds on this progress by exploring whether treatment can be made more tolerable without reducing effectiveness.  

Believed to be the first trial of its kind for prostate cancer, the trial is led by Professor Ananya Choudhury at the University of Manchester and The Christie NHS Foundation Trust. The study, run jointly with University College London, is due to begin recruiting a total of 1,500 patients from hospitals across the country later this month.  

Crucially, the ENHANCE team will ensure that at least 10 per cent of men recruited to the trial are Black. Black men are more likely to get prostate cancer, and to be diagnosed at a later stage, but are traditionally underrepresented in research trials – meaning decisions about their treatments may not be based on data that is as relevant to them. 

Professor Choudhury said: "Patient experience has been central to the design of this trial. We know these drugs can be life-extending, but for many men the side effects are extremely challenging. 

"Throughout the study, we will closely monitor survival and side effects, with a particular focus on fatigue and quality of life. By making treatment more tolerable, we hope more men will be able to stay on therapy for longer and gain the full benefit." 

She added: "ENHANCE is a patient-driven trial, shaped with the help of patient and public involvement groups. It has the potential to make a real difference to people’s lives in a relatively short period of time and even have a global impact."  

For some men, the benefits of reduced-dose treatment are already clear.

Retired solicitor Jonathan, from Cheshire, is among a group of men whose positive response to reducing treatment helped confirm early research findings.

Diagnosed with prostate cancer at the end of 2024, Jonathan struggled badly with the side effects of enzalutamide. When his nurse reduced his dose, his cancer remained under control and his quality of life improved dramatically.

Jonathan said: "It was such a shock when I was diagnosed. I had several health issues and after many tests was eventually told that I was suffering from prostate cancer and that it had spread beyond the prostate wall to my bones. I was referred to The Christie Hospital for treatment and was prescribed hormone blockers. The side effects made me extremely tired; I was sleeping through the day on and off and I had frequent hot flushes and generally felt weak.

"When the nurse suggested lowering the dose I was not sure what to expect. The difference soon became apparent and I felt normal again. I know that I will stay on the medication for as long as it is effective but, in the meantime, I am able to live a pretty normal life. I now exercise more and do not usually need an afternoon sleep. Happily, my PSA level started to go down until, after a few months, it was undetectable and has, so far remained undetectable.

"My life has been transformed by the medication, my energy levels are higher, and I can socialise as normal. Traveling was a problem but now I can plan trips as long as I work around the 12-week cycle of injections and consultations. I am delighted that this trial has the potential to help other men going through the same thing in the future by enabling them to be treated for prostate cancer with their quality of life still largely intact."

Our Director of Research, Dr Matthew Hobbs, said: "No man should be forced to compromise between survival and day-to-day wellbeing. This is a crucial issue for men with prostate cancer.

"That’s why Prostate Cancer UK is thrilled to be working alongside Cancer Research UK, pooling our resources and expertise to deliver the impact men need by funding this bold new trial that puts men’s wellbeing at its centre."

Executive Director of Policy at Cancer Research UK, Dr Ian Walker, said: "Thanks to research, there's been huge progress in prostate cancer treatments. Today, more than 8 in 10 men diagnosed with the disease in the UK will survive for 10 years or more.

"There's more that can be done to save even more lives though, and in addition to finding more effective treatments, we need to find kinder ones too. The ENHANCE trial is looking to do just that and could mean that men affected by prostate cancer live not just longer lives but have a better quality of life."

Please help us fund more research like this. Your donation helps us fund vital research into better ways to treat prostate cancer.