Study Title: FOcal RECurrent Assessment and Salvage Treatment
Short Title: FORECAST
Radiotherapy is a common form of prostate cancer treatment in the UK. About 9,000 men in the UK undergo radiotherapy every year.
One in four of these men will experience failure of their treatment. These men are usually offered hormone treatment. Hormone treatment can have side-effects. Few men are offered a further curative treatment to the prostate. This is due to lack of good imaging tests that can accurately detect whether cancer has come back inside the prostate or or whether it has spread already. Also, because radiotherapy damages the tissue surrounding the prostate tissue healing following further treatment to the whole prostate can have side-effects.
Treating only the cancerous area in the prostate - focal therapy - may limit this damage with fewer side-effects.
We want to see if new imaging tests can better identify cancer that has spread and identify areas of cancer inside the prostate. Our new tests are whole-body MRI (for distant disease) and MRI-targeted biopsies (MRI-TB) (for local disease). First, we will compare the results of whole-body MRI to existing imaging tests (bone-scan, choline PET/CT) that try to rule-out distant spread. Second, we will compare the MRI-TB to a very detailed and accurate biopsy of the prostate called template prostate mapping which will show us where and how aggressive the cancer is. Third, if the cancer is confined to the prostate, we will treat men using focal salvage therapies using either heat therapy or freezing.
We believe that these new imaging tests could better identify those who may benefit from early hormone treatment and those who will benefit from local salvage treatment. Our study may help justify carrying out a larger trial looking at how good focal salvage treatment is in controlling cancer in the medium and long-term.
Sponsor: University College London (UCL)