Prostate Cancer

External beam radiotherapy for prostate cancer came of age with the introduction of high energy linear accelerators in the 1960-80’s. Usage increased dramatically after the introduction of PSA testing in the 1980’s. The dose delivered was limited by side-effects on particularly the rectum, which limited prostate cancer control.

Prostate cancer is the most common cancer in men across Europe, accounting for almost one in four cancer diagnoses in males. Today, surgery to remove the prostate in its entirety is one of three treatment options for early-stage prostate cancers, and some locally advanced prostate cancers – the other options being radiotherapy and active surveillance.

In the early 2010s, many European centres joined forces to form the Prostate Cancer Consortium in Europe (PEACE) to carry out phase 3 trials in prostate cancer field. After about 10 years, 7 projects, PEACE-1 is now the first trial of the PEACE programme to be completed that has put into the market the triplet therapy for patients with metastatic prostate cancer.

Finding out if there is cancer in the prostate and if it is clinically significant has been a major problem because it is hard to image the organ. But magnetic resonance imaging (MRI) has that capability – and the development of MRI technology and its applications including the prostate are European stories. However, proponents have had to battle resistance to its use by some urologists.

Prostate specific antigen (PSA) is the biomarker used for early detection of prostate cancer. It has been one of the most controversy topics in all of medicine, with Europe playing a key role in providing and refining the evidence base for its use.