The £1.9 million clinical trial will recruit up to 1,000 men from over 30 centres around the country to test a new scan that is thought to see more, and smaller, cancer.

Prostate Cancer UK is funding a £1.9 million clinical trial of a scan that could improve the treatment of high-risk prostate cancer.

Led by Imperial College Healthcare consultant urological surgeon Hashim Ahmed, the PSMA PET/CT scan is thought to see more, and smaller, cancer that has spread than the current imaging techniques.

Currently, it is unclear if PSMA PET/CT definitively sees all cancer spread and enables more accurate treatment decisions. The trial will test this, following men for longer than previous trials.

“We know that the way we currently look for prostate cancer spread in men, using a CT and a bone scan, can miss things. A PSMA PET/CT scan means we can look at everything at once and detect smaller lesions, reducing the risk that we miss some cancer spread,” said Ahmed.

The trial will recruit up to 1,000 men from over 30 centres around the country.

Men with high-risk prostate cancer will be divided into two groups. One will receive treatment based on what the current standard imaging tests show. The other group will receive the treatment based on the findings of the new PSMA PET/CT scan.

Both groups will have their cancer treatment decisions made based on the imaging results they receive. If the new scan proves more effective, it could become the standard method for staging high-risk prostate cancer and guiding more accurate treatment for men.

Reliance on imaging

For some men diagnosed with prostate cancer, doctors can tell from their initial biopsy that their cancer is aggressive and more likely to spread outside of their prostate. This is called high-risk prostate cancer. The biopsy, however, cannot tell whether the spread outside the prostate has happened already or not at the point of diagnosis.

To do this, doctors rely on imaging – taking scans of the whole body to check whether any cancer can be seen in places other than the prostate (usually the bones or the lymph nodes). Accurately detecting if and where high-risk cancers have spread is crucial to decide which treatment options are best for each man.

Doctors use two separate imaging tests to check if prostate cancer has spread: a CT scan, which takes detailed pictures of inside the body, and a bone scan, which looks for cancer in the bones.

The problem is that the two imaging techniques are known to miss some areas where cancer has spread – especially when there is only a small amount of disease in those locations. That leaves doctors and men with high-risk prostate cancer the choice between treating only the prostate or treating both the prostate and other possible cancers.