Dr Ian Le Guillou looks back on the past 12 months of prostate cancer breakthroughs, picking out the ones that made the biggest splash and previewing what we can look forward to in 2019.
At the beginning of the year, we revealed that prostate cancer is now the third biggest cancer killer in the UK. A shortfall in research funding has meant that new advances have not been able to keep pace with the increasingly older population, and now the disease takes more lives than breast cancer. The degree of attention given to prostate cancer led to the Prime Minister pledging £75 million towards prostate cancer research.
In March, we announced our latest batch of Research Innovation Awards – almost £3 million invested in exciting new projects such as a potential prostate cancer vaccine and highly-targeted radiotherapy to stop treatment resistance.
The latest findings from the enormous STAMPEDE trial showed that men whose cancer has spread to just a few areas outside the prostate could still benefit from radiotherapy targeted at the prostate. It could have been a case of ‘shutting the stable door after the horse has bolted’, but now we know that it improves three-year survival by 10 per cent in men starting hormone therapy.
Our funded research from the University of Dundee has developed a new type of scan for prostate cancer called shear wave elastography. This special type of ultrasound is able to detect changes in the stiffness of the prostate, a bit like a virtual doctor’s finger.
Back in June, the front pages heralded a simple saliva test to identify men at risk of prostate cancer. Researchers had identified a number of genes that when combined could help to estimate a man’s future risk, with the top one per cent of men having six times greater risk of prostate cancer.
Research that we funded thanks to your support discovered that the immune system can actually help prostate cancer to become resistant to treatments. Now the researchers are testing existing drugs for the immune system to see if they can help treatments for prostate cancer work for longer.
The largest ever study of a type of focal therapy called HIFU (high-intensity focused ultrasound) showed that it could prevent prostate cancer returning within five years in 88 per cent of cases. The treatment works by just targeting the cancerous area of the prostate and is only available in specialist centres, but more evidence is needed to compare it against alternatives such as radiotherapy or active surveillance.
This year, immunotherapy made it into the news a few times for prostate cancer. This revolutionary new type of treatment that triggers the immune system towards the cancer has had some great successes in other diseases, but so far it only appears to work for a very small proportion of men with advanced prostate cancer.
A large group of researchers discovered an additional 22 genes that can increase the risk of prostate cancer. There are already existing drugs that affect these genes, so these can now be tested as potential treatments for prostate cancer.
A new trial of mpMRI scans has shown that using the technology to guide biopsies can detect many more aggressive prostate cancers. These scans are now being rolled out across the UK, with half of men now having access according to our latest findings.
And 2019 promises to be an even bigger year for our research: with preparations almost complete for a landmark five-year trial of a potential screening programme, millions of pounds of new research projects underway and new guidelines for active surveillance due to be rolled out across the UK – all thanks to your generous donations.
Here's to a very happy New Year for everyone!