“Under the radar” prostate cancer targeted by new research to stop disease returning

• In some men with early-stage prostate cancer, the cancer spreads to a part of the prostate where it evades radiotherapy and may not be visible on scans, raising the risk that the disease will come back.
• Researchers at the University of Manchester, funded by Prostate Cancer UK, will develop better ways to treat these men so that the ‘hidden’ cancer is destroyed and the disease is less likely to return.
• 1 in 8 men will get prostate cancer.

Prostate cancer cells can stay hidden in a man’s prostate after he’s had treatment, making it more likely for the disease to come back – but scientists at the University of Manchester are now zeroing in on this, thanks to around £350k from Prostate Cancer UK.

For a man with early-stage prostate cancer, radiotherapy is a common treatment. It uses waves like x-rays to destroy the cancer cells in or around the prostate. When a man has had this treatment, he will have follow-up scans to check that it’s been successful and that the cancer is all gone.

However, for some men who have undergone radiotherapy, microscopic amounts of their prostate cancer sometimes spread to small glands (called seminal vesicles) at the top of a man’s prostate, which may not be visible on imaging scans and can make it more likely that the disease will come back.

Dr Jane Shortall, a Postdoctoral Research Associate at the University of Manchester, is working to prevent this from happening by pioneering a brand-new way to plan, deliver, and follow up on radiotherapy treatments.

Dr Shortall says: “We’ve found that a man’s DNA can affect the likelihood of whether his cancer will spread to these glands at the top of the prostate where it can evade radiotherapy and remain there undetected by scans.

“Armed with this knowledge, we’re working out for the first time how to identify these men whose prostate cancer is remaining ‘under the radar’ after radiotherapy, how to adjust their treatment so that the cancer is eliminated in every part of the prostate, and how to spot the early signs of cancer returning in follow-up scans so it can be treated again as quickly and as successfully as possible.”

Dr Shortall’s project is made possible with £347,111 from Prostate Cancer UK as part of the charity’s Career Acceleration Fellowships, which support the most promising researchers at the beginning of their career, enabling them to make the biggest impact for men with prostate cancer.

As part of this project, Dr Shortall will be working with Professor Tyler Seibert, a renowned expert in prostate cancer and radiology based at the University of California San Diego – linking up cutting-edge UK and USA research.

The research team will analyse samples from thousands of men undergoing radiotherapy for prostate cancer, looking at their blood tests and MRI scans to work out which of these men are most likely to have cancer growing in the seminal vesicles glands that scans can’t see.

When they’ve identified those men, they’ll look at any changes in their blood tests and scans to see how well the cancer in that area at the top of the prostate responded to radiotherapy, and work out how to tweak the treatment in order to target all of the cancer.

Finally, they will scrutinise follow-up tests and scans of men who have had treatment, searching for patterns that could show early signs of a man’s cancer coming back, so that if this does happen doctors can act on it as quickly as possible.

Simon Grieveson, Assistant Director of Research at Prostate Cancer UK, said:

“For a man with early-stage prostate cancer, radiotherapy is an extremely effective treatment — and for lots of men it can be curative. Sadly, however, too many men find out after treatment that their prostate cancer has come back.

“That’s why we fund the latest and most impactful research into the disease, so that every man navigating prostate cancer has a chance of living as long, and as well, as possible.

“We’re excited to support Dr Shortall’s work, which has the potential to optimise and tailor the way men are treated with radiotherapy and ensure that more men do not see their cancer return.

“It’s great that this research is happening in Manchester, as we have seen a shocking North-South divide with more men being diagnosed late in the North West than in London. We’re working tirelessly to address this regional inequality, and to make sure more men know about their prostate cancer risk in the North West and across the whole of the UK.”