Extending men's lives with radiotherapy for advanced prostate cancer

Extending men's lives with radiotherapy for advanced prostate cancer

Every year, around 7,000 men in the UK are diagnosed with advanced prostate cancer. For years, researchers have been investigating whether treating the prostate with radiotherapy could still help men after the cancer had spread elsewhere in the body. To explore this, researchers leading the large multi-arm clinical trial, STAMPEDE, introduced a new arm to test a key question: could adding radiotherapy to the still help men, even if the cancer has spread? Researchers also set out to discover which men might benefit most from adding radiotherapy to the standard treatment once the cancer has spread.

In STAMPEDE, one group of men received the standard treatment — hormone therapy and chemotherapy (docetaxel). A second group of men received the same treatment, with the addition of radiotherapy to the prostate.

After three years of follow-up, the initial results showed no difference in how long men lived between the two groups, suggesting that once the cancer had spread, adding radiotherapy to the standard treatment did not help men with advanced prostate cancer live longer.  However, through your support, Prostate Cancer UK funded a team at the Belfast-Manchester Movember Centre of Excellence to analyse the results in more detail. The team analysed bone scans taken from the men who had participated in the STAMPEDE trial. In total they collected and analysed over 7,000 scans from 140 hospitals.

The team found that men whose prostate cancer had spread to four or fewer places saw a clear benefit from adding radiotherapy. For this group of men, treating the prostate with radiotherapy alongside standard treatment helped them live longer than men receiving standard treatment alone.

After three years, 81% of men whose cancer had spread to four or fewer places and who were treated with radiotherapy were still alive, compared to 73% of men who received the standard treatment alone. This means that, for every 100 men treated, adding radiotherapy resulted in eight more men being alive after three years. 

Kevin Webber was diagnosed with advanced prostate cancer in 2014 and given just two years to live. After receiving radiotherapy, he has continued to defy expectations—raising close to a million pounds for Prostate Cancer UK through epic endurance challenges around the world, while inspiring many others to support the cause.

You can read more about Kevin’s journey and ongoing fight against prostate cancer on his personal blog.

From research idea to access for all

Idea

Researchers wanted to know whether adding radiotherapy to the standard treatment once prostate cancer had spread could still benefit men. They also wanted to find out if treating the prostate at this stage was too late to make a difference. This question was explored as part of the large trial called STAMPEDE. 

Lab research

A team of researchers based at the Manchester-Belfast Movember Centre of Excellence analysed bone scan images from men treated with radiotherapy. The team looked to see if there was a link between the number of sites the cancer had spread to and the benefit gained from radiotherapy treatment.

Clinical trial

The team showed that men whose cancer had spread to four or fewer places benefited from radiotherapy. This group of men lived longer when their prostate was treated with radiotherapy, compared to men who received standard treatment alone.

Thanks to the image analysis performed by our researchers a simple bone scan, used in every hospital, can be used to predict a positive response to radiotherapy to the prostate.

Approved for use

A second team funded by Prostate Cancer UK analysed data from the STAMPEDE trial and a second large European trial that also looked at radiotherapy after the prostate cancer had spread. This independent analysis concluded that radiotherapy should be considered for men whose cancer has spread to four or fewer places. 

Access for all

Work supported by these two Prostate Cancer UK grants provided the evidence NICE needed to update clinical guidelines. Adding radiotherapy to the standard treatment for men whose prostate cancer has spread is now standard clinical practice in the UK. This analysis has also helped shape clinical care in the United States of America and Europe. Thanks to your support, our funded researchers have helped men with prostate cancer live longer across the world.