Prostate cancer is the most commonly diagnosed cancer in the UK, with over 63,000 men diagnosed each year.

While treatment options are well established, our recent research has shown many people feel the information they receive at diagnosis is a lot to take in, with nearly half (47%) of men saying they didn’t feel fully informed when they received a prostate cancer diagnosis and when choosing their treatment options.

This is often linked to how overwhelming the experience of diagnosis can be, with men describing feeling overwhelmed (45%), confused due to lack of clear guidance (36%), or embarrassed to ask questions (26%)^[1] .

As a result, it’s possible, some treatment options may not always be fully discussed. Around a third (34%) of men report not being told about all available treatment choices, including important newer approaches in advanced radiotherapy¹.

Despite this, there is a strong desire for clearer information with 73% of men stating they would want to be told about the latest treatment innovations, and many would consider all options available to them if they understood the potential benefits.

Sadly between 20-50% of prostate cancer survivors experience a relapse within ten years of their first treatment^[2] although this varies depending on individual circumstances, and as many as one in ten patients are not aware that it can return (10%)^[3], highlighting the importance of clear information during and after initial treatment.

If cancer returns in the prostate only after radiotherapy, this is known as a local recurrence and is often first picked up by rising PSA levels (a biochemical recurrence), and several treatment options may be available which are important for prostate cancer survivors to know.

This means many men are making life-changing treatment decisions at the point of diagnosis without fully understanding how those choices could affect their future options if the cancer returns.

If prostate cancer returns but has not spread elsewhere, treatment options may include hormone therapy, radiotherapy, surgery, or, in selected cases, focal therapy and depends on the initial treatment received.

Advances in technology mean it is now safe to carry out repeat radiotherapy (reirradiation); however recent data suggests only 44%^[7] of patients are aware that reirradiation offers a possible treatment option. And for 64% of patients, having this knowledge would have affected their course of treatment.^[8]

Retreating prostate cancer using MRI-guided stereotactic ablative radiotherapy (SABR) delivered on an MR Linac is an innovative radiotherapy technique that aims to effectively treat the recurrent cancer or control the disease and delay the need for hormone therapy. SABR is a specialist technique recognised for its ability to treat tumours with minimal damage to surrounding healthy tissue and is often used as a first-line treatment for prostate cancer.

The MR linac is an advanced radiotherapy machine that delivers MRI-guided SABR. This smart radiation technology combines high-resolution magnetic resonance imaging (MRI) techniques with extremely precise radiotherapy beams that can treat tumours more accurately than conventional radiotherapy.

Dr Yae-eun Suh talks to Jon Holmes about prostate cancer recurrence and MRI-guided SABR

This report aims to provide information for both healthcare professionals and patients about all the latest advancements in treatments for prostate cancer, to help patients make informed decisions about their best course of treatment. 

This one-off episode is written and presented by BBC Radio 4 comedian and writer Jon Holmes - creator of Jon Holmes Says the C-Word. Jon blends our latest research and often shocking data with his unique, raw humour and personal experience of prostate cancer, to prompt important discussions around prostate cancer treatments and the frequency of recurrence. His guests include leading prostate cancer experts and men living with a prostate cancer recurrence diagnosis.

As the UKs leading experts in stereotactic ablative radiotherapy (SABR), we’re proud to have been the first UK healthcare provider to offer reirradiation for locally recurrent prostate cancer using MRI-guided SABR delivered on the MR Linac at our centres in Oxford, London and Surrey.

Our comprehensive prostate cancer pathway includes the latest diagnostic techniques and  innovative treatments such advanced MRI-guided SABR, chemotherapy, immunotherapy, targeted therapies, and personalised exercise medicine. With the expertise of our leading prostate cancer experts, we deliver truly outstanding care.