Better screening and treatment for prostate cancer
Professor David Neal is surgeon and a leading expert on prostate cancer. He and his colleagues in Cambridge are taking a number of different approaches in their work to beat this disease. A particular focus for the team is identifying better ways of distinguishing aggressive cancers from non-aggressive cancers in order to target treatment to the right group of men. Professor Neal is also investigating the genes involved in prostate and bladder cancer.
Prostate cancer screening
Prostate cancer screening currently relies on testing for the presence of a protein called PSA in blood samples, known as the PSA test. High levels of PSA may indicate prostate cancer, but levels may also be raised for other reasons. And some men with prostate cancer may not have a high PSA level. So the test is not 100 per cent reliable.
Professor Neal is a Principal Investigator in a study called ProtecT. This NHS-funded trial aims to determine the most effective treatment for early stage prostate cancer - surgery, radiotherapy or active monitoring (so-called 'watch and wait'). Men have been recruited to the study through PSA screening.
An extension to the trial, funded by Cancer Research UK, is now looking to see whether PSA screening helps save lives or whether it can lead to men being treated unnecessarily. This part of the study is gathering data on men who have not been screened to see how many of them develop prostate cancer and whether their outcomes differ from the PSA screened group in the initial ProtecT trial.
These large and long-term studies hope to address some of the uncertainty around using the PSA test to screen for prostate cancer. The trial is also collecting blood samples for future studies of genes and markers of the disease.
Professor Neal's team is also evaluating a new test for prostate and bladder cancer that measures levels of a protein called MCM5. MCM5 is produced by some cancer cells and can be measured in urine samples. If the test is shown to be effective and accurate, it could change the way that bladder cancer and prostate cancer are detected.
Hormones and growth factors in prostate cancer
The team's work on growth factors and hormones aims to understand why some prostate cancers fail to respond to hormone treatment. Hormone treatment for prostate cancer uses drugs that block the action of testosterone, the male sex hormone, which encourages prostate cancer cells to grow. By studying those tumours that do not respond to such treatment, Professor Neal hopes to discover new ways of treating the disease.
Professor Neal is also studying the genes that can go wrong in different cancers, and how these differ from person to person. Using cutting edge technology, his team hopes to determine the precise 'genetic profile' of particular cancer types - including bladder and prostate cancers. This kind of genetic profiling may enable doctors to personalise people's cancer therapy, for example by predicting how aggressive a person's tumour is or which drugs it will respond best to.
Professor Neal is also an investigator on a new trial called BOXIT which aims to determine if a drug called celecoxib can reduce the chances of bladder cancer coming back.
Listen to an interview with David Neal, discussing surgery for treating prostate cancer, and his research into the disease:
Other research projects by David Neal
Funding period: 01 January 2010 to 31 December 2013