Prostate Cancer: maybe it doesn’t have to be so deadly

23 July, Tim Burton 

We sat down with Prasanna Sooriakumaran, known as PS, to hear how his TUF-funded research could change the prostate cancer landscape.

PS, could you tell us more about the forms of deadly prostate cancer that your research sets out to treat?

Prostate cancer is not a particularly deadly disease if it’s caught early enough. But, if the cancer is not caught early enough, it can spread to the bone, at which point your chances of surviving long-term decrease significantly.

If the cancer reaches the bone, patients will be put on non-curative treatments, like chemotherapy and hormone therapy.

What treatments are you hoping to provide?

Well, it’s been shown in previous research that surgery might improve survival if the cancer has spread to the bone. The problem with these prior studies is that the patients who go forward for surgery are the ones who are younger, fitter, and healthier, and so are more likely to do better anyway. These studies therefore don’t actually answer the question of whether surgery to remove the prostate will improve survival in men with prostate cancer that has spread to the bones.

To answer this question properly, we are conducting a study where some men get surgery and some don’t, but they all get the standard hormone therapy. The key to the study design is that who gets surgery will be allocated at random, so that the two groups of men can be compared fairly. 

Why does surgery work for men in whom the cancer hasn’t spread, but doesn’t always work for men in whom it has spread?

Surgery on prostate cancer patients means removing the prostate. If the cancer hasn’t spread outside the prostate, then you’re completely removing the cancer when you take out the prostate. Hence, in most cases this will work.

However, if the cancer has spread to the bone, you won’t be removing all of the cancer when you remove the prostate. It may still work if the cancer outside the prostate is driven by signals sent from the cancer in the prostate itself. Therefore, by removing the prostate you cut off that cross-talk between the prostate and the sites of disease spread.

What are you hoping to learn from this?

I’m hoping the study will demonstrate that men and their doctors will accept randomisation to surgery plus standard care versus standard care only. This will then allow us to plan a future larger study to examine whether removing the prostate improves survival rates for men with early, lethal prostate cancer. I’m also hoping that the men who undergo surgery will maintain their good quality of life despite the major surgery they’ve had.

What are the next steps with the study?

We have 51 men from across the UK, who have prostate cancer that has spread to the bones and who have volunteered themselves for this study.

The next step is to randomise treatment for this group of men so that some receive hormones and others receive surgery on top of their hormones.

What could this study mean for treatment of the most deadly prostate cancers?

At the moment, one man dies of prostate cancer every 45 minutes in the UK alone. The majority of these deaths are among men in whom the cancer has spread.

If we can prove that surgery can stop or slow down the most deadly forms of prostate cancer, we could help millions of men with prostate cancer across the world. The results of this study are widely anticipated by urological and oncological societies worldwide, and it’s thanks to TUF that the UK leads this important work.

If you want to help us fund more ground breaking projects like this one, you can donate today.

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