Guest blog by Dr Iain Frame, Director of Research

After attending the risk assessment meeting we held last month, where we brought together experts from around the world, Dr Iain Frame thinks we’re on the way to a big change in the way prostate cancer is diagnosed across the UK.

14 Jan 2015

Some of you will have already read Owen’s blog about the risk assessment meeting we held last month. Now I’m really pleased to be able to give you an update on how it went and what came out of it.

The (very) short version is this: the experts came, the meeting happened and the outcomes may very well be life-changing for men at risk of prostate cancer.

This was the first time we’d tried to fund research like this – as an intensive, interactive meeting, where a group of world-class experts came together to find a solution to a defined question. This is different to the way we usually fund research, where we suggest the general themes of research we want to fund (from our research strategy), and then it’s up to the researchers to design the specific question and proposal to answer it. It’s also a bit different because anyone who fits the criteria can apply for a normal grant, but here, we invited specific experts to try to answer our question.

In this case, the question was: can we develop a simple, effective and reasonably priced risk-assessment tool that will be widely used in GP surgeries to first assess a man’s risk of having aggressive prostate cancer and then determine his next steps?

To start with, we were a bit worried that it might be difficult to get such a big group of experts from around the world together for two days just before Christmas, but everyone was really enthusiastic. They all thought it was a great idea and an opportunity to crack a problem that had got researchers all over the world a bit stuck.  

So it was no surprise that they turned up bright eyed on the morning of the first day, ready to get working. We’d put a plan together for how we thought the meeting would go, but it went out the window after the first half an hour. In fact, after we’d explained exactly what we wanted to achieve, the experts effectively put their own agenda together and just got on with it.

After a very busy and productive two days, we had a pretty good idea of what the risk assessment tool would look like, and what we needed to do to bring the science behind it up to scratch. The idea is that the team of experts will start off by using information that already exists to test the science behind the risk-assessment tool. And that’s one of the best things about this research project – we’re not trying to reinvent the wheel. We’re planning to use data that already exists, together with tests and techniques that already exist to build something that will make a real difference in a relatively short time frame.

And we’re not suggesting a move completely away from PSA testing. PSA levels will still be an important part of the information the GP uses to define a man’s risk, but it won’t be used on its own, and GPs won’t be expected to discuss a PSA score with men – instead, conversations might focus on the man’s risk score. Once we’ve tested the behind the scenes science and we’re sure it works, we’ll try it out in a small group of GP practices. We need to make sure it works in real life both for men and for GPs. For men we want to be sure it can effectively assess their risk and reduce the number of unnecessary biopsies. And for busy GPs we need to know that it’s quick and simple enough that they can use and explain it in the usual ten minute appointment.

And if that goes smoothly, well, that’s when we go big and run a much larger clinical trial. Once we’re convinced that we’ve got enough evidence of how well it works, we’ll start getting it rolled out across the UK.

Of course none of this will happen overnight, but it is going to happen. We’re on the way to a big change in the way prostate cancer is diagnosed across the UK – and maybe even the world.

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