Cancer Trial shows treating the prostate with radiotherapy improves survival

Treating the prostate with radiotherapy alongside standard treatment led to an 11% increase in survival for some men with advanced prostate cancer, results from a study funded by Cancer Research UK show.

These findings, from one of the largest ever clinical trials for the disease, were presented at the ESMO 2018 Congress in Munich, Germany and published in The Lancet.

Previously, it was unclear if there was any benefit treating the prostate directly with radiotherapy, if the cancer had already spread. This research helps answer that question and has implications beyond prostate cancer.

The findings from the Cancer Research UK-funded STAMPEDE trial could be practice changing and suggest radiotherapy, alongside hormone therapy, should become the standard of care for a group of men with advanced prostate cancer, affecting thousands every year in the UK.

This part of the STAMPEDE study, based at the MRC Clinical Trials Unit at University College London, involved around 2,000 men who had advanced disease. Half were given standard treatment while the other half received standard treatment and radiotherapy to the prostate €“ the site of the primary tumour.

They found among men whose cancer had spread to their lymph nodes and/or nearby bones and were treated with additional radiotherapy, around 80 per cent survived for at least three years. In comparison, 70%of men who did not have the additional radiotherapy treatment, were alive after three years. The benefit was unique to this group of men, with no increase in survival among men whose cancer had spread further to other organs or distant bones.

Around 47,000 men are diagnosed with prostate cancer every year in the UK, and over 11,500 men die from the disease.

In this study, 40% of men with newly diagnosed advanced prostate cancer were in the group with disease that had spread to their lymph nodes and/or nearby bones, suggesting the findings could potentially benefit more than 3,000 men every year in England alone, and many thousands more worldwide.

Dr Chris Parker, lead researcher of the study based at The Royal Marsden, said: €œOur results show a powerful effect for certain men with advanced prostate cancer. These findings could and should change standard of care worldwide.

€œUntil now, it was thought that there was no point in treating the prostate itself if the cancer had already spread because it would be like shutting the stable door after the horse has bolted. However, this study proves the benefit of prostate radiotherapy for these men. Unlike many new drugs for cancer, radiotherapy is a simple, relatively cheap treatment that is readily available in most parts of the world.€

Professor Nicholas James, chief investigator of the Cancer Research UK-funded STAMPEDE trial from the University of Birmingham, said: €œAlthough survival times are improving, no one with advanced prostate cancer is cured of their disease by hormone therapy alone. These important results move the dial significantly further in terms of what we can do for this large group of men. These results should change the standard of care for certain men with advanced prostate cancer €“ and could be implemented tomorrow.€