Improving the Diagnosis and Treatment of Localised Prostate Cancer

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The way we diagnose prostate cancer at the moment is flawed. At present, a blood test called the prostate specific antigen, or PSA, is used to decide who gets a prostate biopsy. Prostate biopsy is painful, causes bleeding and sometimes serious infections. It often detects harmless cancers that need no treatment and misses important cancers that do. This is because prostate biopsies are random - we cannot see the cancer so needles are fired into the prostate in the hope that we will hit the cancer. Once diagnosed, the way we treat early prostate cancer can cause a lot of harm. Current treatments for early prostate cancer target the whole prostate, causing damage to surrounding structures. This can lead to urine leak, poor erections and back passage problems.The researchI will test the ability of several markers in blood and urine as well as imaging to accurately predict the presence or absence of important prostate cancer. I will also test whether treating the cancer only, in order to avoid damaging surrounding structures, is effective in cancer control and whether the harms of whole-gland treatments can be reduced.The possible benefitsReduce the number of men who undergo unnecessary prostate biopsyReduce the risk of being diagnosed with a harmless prostate cancerImprove the diagnosis of prostate cancer that is importantReduce the harms of treatment