Prostate cancer is the most common cancer in men with 40,000 new cases each year and 10,000 deaths in the UK. In adults, prostate cancer is the second most common cancer. The type of prostate cancer depends on the type of cell that the cancer started in. The most common type are adenocarcinomas. Other types include transitional cell (or urothelial) cancer and this starts in the cells that line the urethra, which carries urine to the outside of the body but this is very rare. Other rarer cancers include squamous cell cancer, small cell prostate cancer, carcinoid and sarcomas.

Treatment for prostate cancer may not happen straight away, instead Doctors will monitor the cancer closely. Depending on the situation, they call this active surveillance or watchful waiting. If the prostate cancer is to be treated then the main treatments include surgery, external radiotherapy, brachytherapy (internal radiotherapy), hormone therapy, high frequency ultrasound therapy (HIFU), cryotherapy, chemotherapy and symptom control treatment. Patients may have one or more of these treatments depending on the stage of the cancer and whether the cancer is low risk, medium risk or high risk.

Survival depends on many different factors including the individual's condition, type of cancer, treatment and fitness level. For men with prostate cancer in England and Wales, around 95% will survive their cancer for 1 year or more, almost 90% will survive their cancer for 5 years or more and more than 80% will survive their cancer for 10 years or more.

Prostate cancer is often slow-growing, but more aggressive forms of the disease are hard to treat. Scientists and clinicians in Cambridge are working together to understand the molecular changes that occur before and during the early stages of prostate cancer.

As part of a comprehensive high quality surgical service, Addenbrooke’s Hospital runs the largest prostate cancer surgery service in the UK. Robotic surgery has reduced average in-patient stays from six days to one and results in much improved quality of life following surgery. Almost all prostate operations are carried out using this technique at Cambridge, compared to a national average of 20%.

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The largest randomised control trial of surgery, radiotherapy and active monitoring of localised prostate cancer, which will produce a risk-based gold standard of management.

We are carrying out studies of the protein receptor for the male sex hormone, the androgen receptor (AR), which is critical to prostate cancer development and growth. We have identified AR regulated genomic signatures that predict outcomes, which is exciting because it may be possible to identify which men are likely to progress after radical treatment and how to target aberrant molecular pathways to improve treatment. We have developed the concept of ‘window trials’, which are studies done using imaging and biological end-points in men treated with short courses of novel drugs prior to surgery or radiotherapy. These studies are important for patients, science and for pharmaceutical companies.