by Hannah Kerfoot
Men’s Health Week was back in June, where Pharmora provided an overview of health conditions affecting men, including prostate cancer. September is Urology Awareness month, which also had a theme championing Men’s health. In researching these men’s health initiatives, combined with our experience of supporting clinical trials investigating treatments for different cancers, Pharmora recognised that there is a changing landscape in the treatment of Prostate cancer. We thought it worthy of its own blog in order to properly discuss this disease that so many men are at risk of. 
Frequency of Prostate Cancer
Prostate cancer is the most common cancer in men, with around 55,100 new cases every year in the UK and 299,010 new cases in the United States, according to Cancer Research UK and the American Cancer Society. Men have a higher risk of prostate cancer as they increase in age, with 35% of newly diagnosed prostate cancer in men aged 75 or above. Men are advised to make an appointment with their clinician and to have their prostate checked if they notice any pain while urinating.
Types of Prostate Cancer
Prostate cancer can be classified into three groups: localised, locally advanced, and metastatic, according to the extent of spread in the body at the time of diagnosis. This determines the treatment modalities that can be used.
It is also divided into hormone-resistant (also known as “castration-resistant”) and hormone sensitive types, depending on the markers on the tumour cell surface that determine whether it will respond to certain types of therapy.
Early Detection
Despite the increasing rate of prostate cancer diagnoses, the mortality rate from this cancer has been decreasing over the last decade in the UK, which may be due to detecting it earlier. Unfortunately, while the 5-year survival rate for localised prostate cancer is an impressive 99% it drops dramatically to 34% when it is diagnosed at the metastatic stage, demonstrating the importance of early diagnosis.
Advances in detection
Currently, prostate cancer is usually diagnosed using a combination of clinical examination and a Prostate Specific Antigen (PSA) test, followed by further investigations.
PSA testing is prone to false positives, particularly because it may be raised due to Benign Prostatic Hypertrophy or activities such as cycling, but also because it also detects slow growing prostate cancers that would never have caused a problem. This may lead to invasive biopsies, unnecessary treatments and impact on mental health.
A recent study by the Institute of Cancer Research and the Royal Marsden NHS Foundation Trust provided evidence that a new DNA test, which looks for genetic variants linked to prostate cancer in a simple sample of saliva, could be useful in diagnosis. This study found that the test could predict those men who were most at risk of developing prostate cancer, particularly the more aggressive types of cancer, and even picked up a tumour that had been missed on MRI scan. A home saliva test could be a more convenient and a potentially more accurate detection method in comparison to PSA testing.
Breakthroughs for Men’s Health
Men’s Health Week and this year’s Urology Awareness Month theme were particularly exciting for Pharmora as they gave us an opportunity to celebrate all the support we have provided over the years for products to improve men’s health. This includes medical review of clinical trial data for potential therapies in development and safety evaluations for products in clinical trials and on the market.
The initiatives come hot on the heels of the annual Association of Clinical Oncologists (ASCO) Annual Meeting in 2024, where a wealth of emerging data was presented on exciting new treatments for cancer, including some of those from our clients. We have helped clinical trials meet key milestones (including recruitment, data base lock, safety reporting, and CSR writing, including safety narratives) and provided seamless, assured medical services to meet our clients’ needs. We are proud to have contributed to some of these scientific breakthroughs!
Highlights from ASCO:
The landscape of treatment for prostate cancer is changing very quickly at the moment, with new potential treatments being identified and lots of research ongoing in this area.
Promising results from a clinical trial (Read it here) in metastatic castration-resistant prostate cancer were presented. These results showed a significant and clinically relevant improvement in progression-free survival when 6-cycle chemotherapy with cabazitaxel was added to abiraterone in men who had been previously treated with docetaxel. However, although the study met its primary endpoint, the medical opinion was not massively positive. Because of improvements to front-line treatments for prostate cancer this population of men (previously treated with docetaxel) may no longer exist in the future – therefore more trials are needed to define this therapy area (Watch the video here).
Another point of interest in ASCO was using Artificial Intelligence in diagnostic imaging for prostate cancer. Earlier this year, our CMO Dr Stephanie Jones voiced her thoughts on the topic of AI (Read more here), and in medical imaging there remains hope for what AI could bring. AI could potentially improve:
- Quality control/quality improvement
- Organ segmentation
- Lesions detection/segmentation
- Treatment planning and staging
- Metastatic staging
- PSMA PET/CT acquisition
Similarly, on the topic of diagnostic images, the Imperial London PROSTAGRAM study involved the screening of men with MRI, ultrasonography and PSA testing. This study’s aim was to determine whether MRI could be a superior screening tool for prostate cancer, compared to invasive biopsy, ultrasonography and PSA testing. The study found that a short, non-contrast MRI may have favourable performance characteristics as a community-based screening test since there was improved detection and no increase in biopsy or overdiagnosis instances.
As stated earlier, with the constant advancement in the area, it could be argued that even this study won’t be completely up-to-date with the current medical situation; for example the introduction of a spit test for diagnosis of prostate cancer could once again change the diagnostic landscape and create a need for more studies.
Prostate cancer research is a fascinating and constantly evolving area of study, which we at Pharmora are honoured to be a part of.
