Some cancers are extremely aggressive and spread quickly, whilst others can be very slow and may never do any harm to a man during his lifetime. We need to make sure once men are diagnosed they are offered the right treatment based on their specific cancer.
Sometimes it is clear cut but, especially at the early stages, it can be difficult to tell how a cancer might develop so it’s not so black and white. Men in this ‘grey area’ face a difficult decision: Do they choose treatment like surgery or radiotherapy and run the risk of a lifetime of side-effects? Or do they opt for active surveillance, where the cancer is closely monitored but untreated? It’s a horrible choice to have to make.
Professor Paula Mendes (pictured above) hopes to make this an easier decision, by helping to identify aggressive cancers more accurately. By donating today, you could help us tell the difference between aggressive and non-aggressive cancers, and give men a clearer picture of what they are facing.
Professor Paula Mendes, who was awarded one of our Research Innovation Awards, is developing a new type of blood test to identify different forms of the PSA protein that are linked to more aggressive cancers.
Professor Mendes is using specially designed nanoparticles to take an entirely new look at the PSA test and give us crucial information about a man’s cancer. In the next two years, she hopes to run her test against samples from men with aggressive cancer, non-aggressive cancer and no cancer. This will measure the accuracy of this test in the hopes of rolling it out more widely.
One day this technology could be used to detect prostate cancer in the first instance – the long-term aim is to replace the PSA test
Active surveillance has been one of the unsung breakthroughs in prostate cancer. For decades, any prostate cancer was treated with little regard for its potential to do more harm than good. But today, many men on active surveillance with clearly nonaggressive cancer have been able to avoid or delay side-effects from treatment.
For men like Robin Porter, it’s not always so clear cut. When Robin was initially diagnosed with prostate cancer he wanted to have surgery, but after a second opinion from an oncologist, he decided to go on active surveillance. Twelve years on, his cancer has remained under control and he has avoided surgery and the possible side effects. But not all men are as lucky as Robin.
The downside of being on active surveillance is that you do have a level of stress. When you go for the tests you are always thinking, well is this the time when they’re going to say, ‘Sorry, Robin, you’re going to need the operation'
After a raised PSA result, John had his PSA levels monitored for several years as they slowly climbed. Two biopsies later John finally had a diagnosis of prostate cancer and he chose to have treatment. However, he can’t be sure how aggressive his cancer might have been or if it would have remained slow growing and harmless.
There are thousands of men, like John and Robin that fall into a ‘grey area’ when first diagnosed and can’t be sure if treatment or active surveillance will be better for them. This simply isn’t good enough and it’s why we need this new test - these men deserve a clearer picture of what they’re facing. For both Robin and John, this could have helped them to be more certain of their treatment decisions and eased their uncertainty. This uncertainty creates a lot of anxiety and it’s a common reason why men call our Specialist Nurses for support.
With a better test to tell the difference between aggressive and non-aggressive cancers, more men could do the same. A clearer picture of their cancers will help men to feel more confident in making the right choice for them.