Owen Sharp, CEO at Prostate Cancer UK sheds light on the important work that’s being done to better diagnose and treat prostate cancer
Most prostate cancers aren’t a problem. In fact, for many, the problems only come from diagnosing and treating them. These are the prostate cancers a surgeon once described as ‘pussycats’. Most men in their 50s will have some cancerous cells in their prostates, and most of those will never need to know about them. They won’t cause symptoms or problems, and won’t grow any further.
The trouble is that some of those men don’t have pussycat cancers. They’ve got tigers; fast-moving, aggressive, and often fatal. And those tigers kill one man every hour in the UK.
So arguably, the questions we need to answer to make a huge difference to the lives of men diagnosed with prostate cancer are: how can we tell the tigers from the pussycats? And, how can we take the claws (and teeth) out of the tigers, when we find them? Usually, the answer lies in early detection and early treatment. That is absolutely true for prostate cancer too, but with a hefty caveat.
Early detection and treatment of the pussycat prostate cancers leave men open to an unnecessary risk of infection from biopsy and of serious treatment side effects, like incontinence and erectile dysfunction. So to make a real difference to these men, we need to find a way to accurately assess their risk of having aggressive prostate cancer, and be able to tell them – with confidence – that they don’t even need a biopsy, let alone radical treatment if their risk is low.
There’s a huge amount of work going on across the UK, much of which is supported by Prostate Cancer UK and our charity partner The Movember Foundation, into understanding the genetic basis of prostate cancer risk, improving imaging techniques to reduce the need for biopsies, and discovering new biomarkers to identify aggressive disease, to name but a few. As well as developing a new tool to help men and GPs identify a man’s personal risk of having aggressive prostate cancer. All these avenues of research have the same goal in mind: reduce over-treatment of the pussycat prostate cancers, and under-treatment of the tigers.
But what about the men with advanced prostate cancer who are already caught in the tigers’ jaws? The key there will be well designed clinical trials of ‘smart’ drugs. To make these drugs, we’ll need to understand more about the ins and outs of each man’s cancer; what his, and his cancer’s, genetic make-up can tell us about which treatments will and won’t work for him, and how long they’ll work for. We also need to know more about how to use the drugs we’ve already got more efficiently. Research can help us there too, and again, that work is ongoing. For instance, only last week, we heard that the world’s largest-ever prostate cancer clinical trial had reported a clear survival benefit in treating men with docetaxel chemotherapy, alongside hormone therapy from the point of diagnosis with metastatic prostate cancer, instead of just after hormone therapy fails.
Yet science can only take us so far. We will always reach a point – as we have now with the recent trial results – where research identifies a new ‘gold standard’ to improve the lives of men with prostate cancer. Then the scientists have to pass the baton to those who have the keys to access.
That’s why now, more than ever, it’s important that we all, men; researchers; health professionals; health providers and charities, work together to make sure that new technologies are made available quickly and universally across the UK.
Taming a tiger was never going to be an easy job. But it is possible. We’re ready to be bold, and dynamic in pursuit of this ambitious goal. Are you ready to join us?
Prostate Cancer UK
Tel: 0800 074 8383