Turning a negative into a positive, and extending lives

Every year 7000 men are diagnosed with advanced prostate cancer. Until recently it's been thought that treating prostate cancer that has spread outside the prostate is not worthwhile. However, researchers leading the large multi-arm clinical trial, , believed that we need to make sure that that was the case. To test this they added radiotherapy to the prostate as a new arm in their trial. 

One group of men were given the standard of care which was hormone therapy, and chemotherapy (docetaxel). A second group of men were given the same treatment as the first group with the addition of radiotherapy to their prostate.

After 3 years of following up there was no difference in how long men lived after the two different treatments. Whether men were treated with the standard of care or with standard of care with radiotherapy they lived for the same amount of time. On the surface this appeared to be a negative trial showing that the original theory – that treating the cancer in the prostate in these men did not improve survival once the cancer had spread. However, through your support, Prostate Cancer UK had funded a team at the Belfast-Manchester Movember Centre of Excellence to analyse the results in more detail. That team analysed bone scans taken from the men who participated in the trial. In total they collected and analysed over 7,000 scans from 140 hospitals.

The team showed that for men whose prostate cancer had spread to only a few places (4 or fewer), having radiotherapy gave them significant benefit compared to standard of care alone.

From research idea to access for all

Idea

Researchers wanted to know if men whose prostate cancer has spread outside the prostate would still benefit from radiotherapy given to the cancer still within the prostate, or if giving radiotherapy at this stage (once cancer has spread) is too late. This was part of a large trial called STAMPEDE.

Lab research

A team of researchers based at the Manchester-Belfast Movember Centre of Excellence analysed images of bone scans 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, with the benefit given with the radiotherapy treatment.

Clinical trial

The team showed that men whose cancer had spread to 4 or fewer places did benefit from radiotherapy to the prostate-they lived longer than men who hadn't been given radiotherapy.

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 once the prostate cancer has spread. This independent analysis concluded that radiotherapy should be considered for men whose cancer has spread to 4 or fewer places. 

Access for all

Work done through these two Prostate Cancer UK grants provided the evidence NICE the needed to change clinical guidelines. Not only is this now standard clinical practice in the UK, this analysis has also changed clinical practice in United States of America and Europe. Because of your support, our funded researchers have extended the lives of men with prostate cancer across the world.