Many men with ‘high risk’ prostate cancer may have a tumour that has already spread outside the prostate to the pelvic lymph nodes. However, this is extremely difficult to detect, because cancers that have spread to the pelvic lymph nodes are often too small to be seen by conventional imaging. This means that men are at risk of being under-treated, because the cancer is too small to see, so doctors think it isn’t there.
Alternatively, men might be given additional radiotherapy to target their lymph nodes ‘just in case’, which they don’t actually need. Additional radiotherapy can mean additional side effects, so we need to get better at working out which men need radiotherapy to their lymph nodes, and which men don’t to avoid unnecessary side effects.
The researchers will analyse huge amounts of existing data to develop a tool that will help them work out which men with ‘high risk’ prostate cancer need extra treatment to reduce the chances of the cancer coming back.
The team in Manchester will use data about the radiotherapy doses that previous patients received, and make an atlas to show how the dose given to the lymph nodes affects their survival. This will then be combined with information from each man, which the researchers will study to see if it would be possible to work out in advance whether or not a man is likely to benefit from having radiation targeted towards their lymph nodes or not.
If successful, this model may help work out which men need radiotherapy that specifically targets their lymph nodes, and which men can be spared additional radiotherapy, and additional side effects, that they don’t need. The results of this project will feed into a future clinical trial aiming to improve outcomes for men with high-risk prostate cancer by targeting radiotherapy to those who need it most.
Reference - RIA15-ST2-031
Researcher - Dr Ananya Choudhury and Professor Marcel van Herk
Institution - University of Manchester
Award - £224,739