Prostate cancer diagnosis research, which was originally funded by the Basingstoke-based charity Pelican Cancer Foundation, is giving new hope for more effective treatment of patients in the future.

Recent news of a major breakthrough in prostate cancer diagnosis, through the use of multi-parametric MRI scans, revealed that the new method could almost double the detection of aggressive tumours.

The findings of the clinical study, initiated by former Pelican Research Fellow Hashim Ahmed who carried out early trials in London and Basingstoke, could save more lives and prevent around 25,000 men in Britain from painful biopsies every year.

The original study into the treatment of prostate cancer, the most common cancer in British men, was seed-funded nine years ago by the Pelican Cancer Foundation. The charity supports medical research and education to improve precision surgery, detection and treatment of bowel, liver, bladder and prostate cancers.

Initially, Hashim Ahmed received £300,000 funding from Pelican as a Junior Research Fellow to carry out the three year study into the viability of using MRI scans to diagnose prostate cancer, and also the treatment of the disease using Focal Therapy. He has recently been appointed to Professor and Chair of Urology at Imperial College London.

“The diagnostic part of the study was used to guide the treatment, with the precision imaging from the MRI scans enabling us to pinpoint the cancerous cells much more effectively,” said Professor Ahmed.

Working in a close-knit team, led by Professor Mark Emberton and with radiologists Alex Kirkham and Clare Allen, he discovered that the scan images of the prostate were much more precise in locating the cancers

“Traditional biopsy testing to date has been very inaccurate because the samples of tissue are taken at random and we can’t see if cancers are present during the procedure. Our MRI scan results showed us if there was any cancer present. And where there is no significant cancer present on the MRI scan, then those patients can safely avoid an immediate biopsy.

“Significant cancers can be treated earlier which should have a real impact on long-term survival.”

Professor Ahmed’s most recent study, funded by the National Institute of Health Research and run by the Medical Research Council Clinical Trials Unit, was published in The Lancet. It showed that 93 per cent of aggressive prostate cancers were detected through MRI scans compared with just 48 per cent of cancers detected through traditional biopsies.

“After the Pelican research, my career was given a boost. I received Medical Research Council Fellowship funding for my PhD and then another fellowship from the MRC of £1.2M, which enabled me to continue my studies into prostate cancer diagnosis and treatment,” said Professor Ahmed.

“The research took this long to evolve because expertise was required and we needed to refine the technology before we could carry out the four year study – and that required a lot of resources.

“There was also some scepticism at first from medical professionals and academics. But when the MRI scanning results proved so effective, Mark Emberton and I were pleased to spread the news. We gave lectures and published articles and raised awareness – it was the culmination of many years’ research.”

The National Institute for Health and Care Excellence (NICE) is reviewing the study’s findings to determine whether they should recommend it as standard in their guidelines to the NHS and Professor Ahmed welcomes this.

“Britain’s clinicians and hospitals will have to consider whether MRI tests can be incorporated into their local pathways – by using biopsies alone, we have shown that men will have their diagnosis compromised,” he said.

His work is continuing with the support of a £2m Fellowship from the Wellcome Trust, the world’s largest medical research charity. He hopes his studies will enable more high risk men, those with a family history or from high risk ethnic groups, for example, to be screened in the community by an MRI – similar to the UK’s mammogram screening service for women.

“To move forward with MRI scans, we need improved technology,” he explained.  “We have to develop the right tools and IT software for a computer-aided diagnostic programme that can be used by medics at clinics around the country. By raising awareness of prostate cancer, we will be able to improve the outcomes for many men who suffer from this disease.”

“We are delighted to see the ground-breaking results of Hashim’s studies,” said Pelican’s Chief Executive Sarah Crane.

“The informed work of our former Research Fellow will make a positive impact on the diagnosis and resulting treatment of prostate cancer patients in the future if it becomes NHS clinical practice. It will make a real difference to so many lives.”

If you’d like to read more about the research we’ve funded – click here.

 

Nick is a colorectal registrar surgeon at Basingstoke Hospital and former Pelican Research Fellow. While at Pelican Nick worked on our

flagship Mercury II study and developed POLARS, a mathematical model used to help doctors and patients understand the level of risk of poor bowel function following rectal surgery.

Read on to find out more about Nick and how Pelican have helped his research and work.

Why did you apply to be the Pelican Research Fellow? What did you want to achieve?

As a surgical registrar with an interest in colorectal surgery it was very apparent that rectal cancer patients require a great deal of thought.  Essentially this is because we need to ensure the cancer is optimally treated whilst minimising the consequences of treatment—particularly because quality of life can be hampered by poor function and/or a permanent stoma. The Pelican Research Fellow position has a track record of delivering high quality research, is a full-time research post and gave me the opportunity to work with world leaders in surgery, pathology and radiology.

What did you learn while you were the Pelican Research Fellow, and how has this influenced your career subsequently?

 

It has given me an academic outlook and sparked a life long interest in clinical research. Broadly, it has taught me how to design a clinical trial, recruit multiple centres, accurately and ethically collect data, and how to then share the results with the medical community, through presentation and papers. It has really helped me think critically and not just accept the status quo. Only then can you really improve patient outcomes. Practically, this means that it is possible to identify where clinical problems exist and it gives me the insight and confidence to do something about these problems. This has happened with bowel related quality of life (see POLARS) and with some future projects that I’m collaboratively involved in. It has also allowed me to return to Basingstoke as a trainee surgeon. Basingstoke focuses on precision surgery for colorectal cancer and having the opportunity to be trained by these surgeons has dramatically improved my technique and my surgical understanding.

 

What research are you working on at the moment?

 

There are two projects that I recently applied for funding for – so hopefully I can discuss those with you another time! I am also involved in the TRIGGER trial, which Pelican has funded.  This is a complex trial and has taken quite a long time to set up. We now have three centres that are actively recruiting patients and 15 that are in the set-up stage. At the centres already recruiting we have had a really encouraging response, the Royal Marsden has nearly recruited 30 patients already!

Click here for more information about the Mercury II Study

Click here for more information about POLARS