Research is boost to prostate cancer battle

12 March 2018
Cambridge University Hospitals (CUH) has developed a new five-tier model that will help consultants better counsel and treat the rising tide of prostate cancer patients.

It comes as figures show the number of men dying from the disease is overtaking women dying from breast cancer, and celebrities like Stephen Fry publically share their experiences to encourage men to get tested.Vincent Gnanapragasam

Called the Cambridge Prognostics Group (CPG) model, it will help doctors better identify which are the so-called aggressive “tiger” cancers, which are the sleeping “pussycats” - and which are somewhere in between. 

Once the tier is identified, patients and consultants can have more informed discussions on the best way to manage a condition, be it through radiotherapy, surgery or active surveillance.

Details about CPG have just been published in a paper by CUH urology and research lead and consultant urologist, Mr Vincent Gnanapragasam, who is also uro-oncology lecturer at the University of Cambridge and Urological Malignancies programme director co-lead at Cancer Research UK Cambridge Centre. Development started in 2016, using data from over 11,000 UK men.

Drawing on his international contacts, Mr Gnanapragasam has just retested the model using data from more than 75,000 patients in Switzerland and Singapore, which was analysed with the help of academics at Manchester University.

The results show that the model, which draws of readily available diagnostic data, is consistently superior to the three tier system currently recommended for use.

 The results have been passed on to the National Institute of Clinical Excellence (NICE), for consideration of adoption as national best practice.  The CPG model is also being developed into a web based freely accessible tool.

Meanwhile patients at the trust’s famous Addenbrooke’s Hospital are already benefiting from the model, which has been built into the hospital’s EPIC computer system.

Mr Gnanapragasam, who last year made headlines for developing a new prostate biopsy device called Camprobe, said: “Some newly diagnosed tumours will be aggressive - while many others will have an indolent natural history. Understanding the likely progress is critical for giving patients precise information tailored to their own situation and for planning management. This model is a significant improvement on how we have done this historically and we can now predict a cancers’ likely behaviour with a very high degree of accuracy.

“The beauty of it is that the CPG model has zero costs and is easy to reference as it exploits routinely collected and standardised diagnostic data.

“We propose the adoption of the CPG model as a simple to use but more accurate stratification tool to help guide management for men with newly diagnosed non-metastatic prostate cancer.”

Professor Richard Gilbertson, who is Director of the CRUK Cambridge Centre, as well as the Li Ka Shing Chair of Oncology and Head of Department of Oncology, added: “The increasing appreciation that each type of cancer is made up of numerous subtypes, each likely to need different treatments, is transforming the way patients with cancer are managed.  

“The CRUK Cambridge Centre is leading research into more accurate methods to diagnose and stratify cancer, in this case prostate cancer, providing them with the best chance of cure with the least side effects.”