When Nick was offered chemotherapy to treat his advanced prostate cancer, he decided to take a different approach, and signed up to take part in a clinical trial. He got access to cutting-edge treatment and decision making, while knowing his experience might directly benefit future generations of men.
Before new treatments or medical procedures can be widely used, it’s essential they’re tested in clinical trials. This helps make sure new treatments are safe, and shows if and how much they’re better than existing therapies. But clinical trials can have big advantages for the men who take part too, including access to cutting-edge treatments not yet available in the clinic, and the chance to make a difference to the lives of men in future.
However, making the decision to be part of a clinical trial can be difficult. Knowing you’ll be among the first to try a new treatment is daunting, and it’s important men have all the information they need to help them decide. We hope our brand-new clinical trials map can help by giving men an easy way to find out what trials we’re funding and where.
For Nick, taking part in a clinical trial felt like a no-brainer. We caught up with him, to find out why he chose to take part in our clinical trial, CTC STOP.
In November 2013, Nick, an ex-RAF engineer officer, was enjoying a well-earned retirement with his wife when he was diagnosed with advanced prostate cancer.
“They initially put me onto hormone therapy, which I bumbled along on for quite a long time. But in early 2016 my consultant told me the therapy was no longer controlling the cancer and I moved onto enzalutamide for just over a year, until that eventually stopped working too. She then said, we’ve got chemo, or there’s another option, you can go on a trial. I said yes, I was all for it.”
Thanks to his background in the RAF, Nick was no stranger to trials, even if they weren’t clinical.
“I was a trials officer on helicopters back in the 1970s, and in my last years of service and after I retired I was doing trials on military explosives.”
Clinical trials are the last of many stages to take research from the lab to clinical practice. They aim to rigorously prove whether new treatments or procedures can really help men, and for this, they need numbers.
“I know from my background that people doing trials must have data – a lot of data. Without it, you may start blundering down the wrong path. So I was more than happy to embark on the trial.”
The trial is called CTC STOP, and it’s trying to make chemotherapy more personalised for men like Nick, whose prostate cancer has spread to the bone and become resistant to hormone therapy.
Professor Johann de Bono is leading the trial. “We have several kinds of chemotherapy to treat prostate cancer at this stage,” he explained, “but they don’t all work forever, or all work the same for different men.”
“The trouble is, it’s not easy to tell when these drugs are, or aren’t, working. This means men are wasting precious time on treatments that are no longer giving them any benefit, while other drugs that could help sit on the shelf unused.”
In this trial, the team are testing a new method to tell whether or not a treatment is working – by measuring the number of ‘circulating tumour cells’, or CTCs, in men’s blood. CTCs are cells that have escaped from the prostate cancer into the bloodstream. Importantly, the team have discovered that when a cancer is responding well to treatment, numbers of CTCs in the blood drop.
By monitoring CTC levels during men’s chemotherapy treatment, the team hope they can be quicker to react when a treatment stops working, and get them onto the next type of therapy.
“There are two sides to the trial,” Nick said. “In one group, the researchers know what your CTC count is, and change treatments accordingly. In the other they don’t, so they can compare results and work out if using CTC counts to inform treatment choices is beneficial. I’m on the half where we were given the information, so as we went along they could tell me what my CTC count was.”
“The team are extremely good. They’re obviously highly qualified, and kept me informed along the way.”
“I went as far as nine cycles on docetaxel chemotherapy. Then I was warned by the research team that things weren’t so good, and I should go onto the next stage of chemo in the trial, which was cabazitaxel.”
If I hadn’t been taking part in CTC STOP, I may have continued to be treated with Docetaxel when another drug would have been more helpful.
“The trial enabled them to make that decision. If I hadn’t been taking part in CTC STOP, I may have continued to be treated with docetaxel when another drug would have been more helpful.”
“As it happens the team stopped my treatment with cabazitaxel after two cycles as my CTC count indicated it was not working. I have now entered a trial of a radionuclide therapy, which delivers radiation directly to tumours to kill them.”
For Nick it’s a win-win. He has access to cutting edge ways of treating prostate cancer, that may very well improve his outcome and he’s contributing to research that will help future generations of men.
"Being on a trial doesn’t necessarily mean you’ll see any additional benefit yourself – although in my case they used it to take me off one chemo onto another – but somebody further down the line will."
To find out more about whether you, or someone you know, is eligible for CTC STOP, contact your medical team or call our Specialist Nurses. You can also go to our clinical trials map, to learn about the other trials we may be funding in your area.