1. Both robotic and open surgery achieve similar results at 3 months

The first stage of a two year study published in the Lancet, reports that both robot-assisted laparoscopic prostatectomy (RALP) and radical retropubic prostatectomy (open) surgery for localized prostate cancer achieve similar outcomes at 3 months. This Australian study, composed of 308 men, is the first randomised controlled trial to compare robotic vs open surgery for the treatment of localized prostate cancer. There was no significant difference between open vs RALP groups at 12 weeks post surgery for urinary (83.80 vs 82.50; p=0.48) or sexual (35.00 vs 38.90; p=0.18) function or proportion of positive surgical margins (10% vs 15%; p=0.21).  There was a tendency, which did not reach statistical significance (p=0.052), towards lower postoperative complications in the RALP group (2%) compared to open surgery (8%). According to the 2014 BAUS Surgical audit of radical prostatectomies in the UK, RALP accounted for 59% of surgeries, while open surgeries were performed in 13.4% of the cases. Reporting on longer-term follow, at 24 months post-surgery, is expected, and will include analysis of urinary and sexual function and oncological outcomes including positive surgical margin status and evidence of progression. This will be important to fully assess the efficacy of both treatments in terms of long-term side-effects and cancer survival.

You can read more about this study on the news section of our website here.

2. Men with advanced prostate cancer more likely to inherit gene mutations than men with localised disease

A new study published in the New England Journal of Medicine has shown that men with metastatic prostate cancer have a much greater chance of carrying a germline mutation in DNA-repair genes such as BRCA1/2 and ATM than those with localized disease. The ICR team, led by Prof. Johann de Bono, sequenced 20 DNA-repair genes that are associated with cancer-predisposition from 700 men with aggressive disease. These men had an 11.8% chance of carrying a germline mutation in genes that are responsible for maintaining DNA integrity compared to a 4.6% chance in men with localized prostate cancer. Significantly 71% of men with DNA-repair gene mutations had a first-degree relative with a cancer other than prostate cancer compared to only 50% of men without the DNA-repair gene mutations. Although these are early results this study has two clear implications. Firstly, testing men with prostate cancer for the presence of these mutations may allow their treatment to be personalized, for instance with the addition of PARP inhibitors which have been shown to have anti-tumour effects in other cancers with DNA-repair mutations. Secondly, just as BRCA1/2 mutations are used to screen for women at high risk of developing breast cancer, men who have a close family member with advanced prostate cancer may be tested for these mutations which would identify if they have a higher risk of developing prostate cancer themselves.

You can read more about this study on the news section of our website here.  

3. Patients taking statins are almost half as likely to die of prostate cancer

Adding to the growing evidence about the cancer-preventing properties of statins, a study of 22 667 cancer patients out of Aston University in Birmingham found that patients who were on the cholesterol lowering drug were up to 47% less likely to die of their disease. The study presented at Frontiers in CardioVascular Biology (FCVB) 2016 prospectively examined the outcomes of people who had been admitted to hospital between 2000 and 2013 with prostate, breast, bowel and lung cancers. The largest effect was seen in prostate cancer, where after taking into account factors such as age, gender or ethnicity, researchers found that prostate cancer patients who had previously been diagnosed with high-cholesterol were 47% less likely to die than patients with normal cholesterol levels. As 9 out of 10 patients with high cholesterol were taking statins, the authors propose that increased survival is linked to statin usage and call for a clinical trial to more closely examine the connection between statins or other cholesterol-reducing drugs and cancer. While there is currently no evidence to support this, future research will be important to explore if statins could be effective in patients without high cholesterol levels.

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