The Prostagram trial investigated the use of MRI scans to detect prostate cancer. At present, there is no nationally approved screening programme for prostate cancer. The most common test, prostate-specific antigen (PSA), is unreliable and can suggest prostate cancer when no cancer exists. This can result in some men having invasive, and sometimes painful, biopsies for no reason. In addition, up to 15% of men with prostate cancer have normal PSA levels, so many cases may be missed.
The importance of patient involvement
Derek Price, a consumer member of the NCRI Prostate Group and member of the NCRI Consumer Forum, was the first patient representative to join the Prostagram trial management group, the group responsible for the day-to-day management of the trial. Derek played a crucial role on the trial management group expressing opinions from the patient’s viewpoint.
The Prostagram trial needed to recruit men from GP surgeries and the community and the patient recruitment strategy was crucial to the trial’s success. Derek was involved in developing the recruitment strategy and he was able to comment on posters designed to encourage recruitment, using his network to receive feedback from men in the community.
Derek was also involved in the development of communications with trial participants. This included invitation letters, patient information sheets and communications of test results. This is a vital role that patients and the public play in the development of clinical trials – ensuring trial information is accessible to patients. Derek inputted into the communications approach as well as specific wordings of the communications.
“I hope that my involvement may, in some small way, helped in trial recruitment, helped men to better understand the patient information and helped them understand their results letter and ease any worries concerning this.
Derek Price, NCRI Prostate Group Consumer Member
Prostagram: Taking the fear out of prostate cancer testing
Over 400 patients received an MRI scan. This was alongside the standard PSA blood test to see if the MRI was better at identifying prostate cancer and could mean men could avoid invasive examinations. The MRI scan was found to be better at detecting aggressive cancers than PSA in the 4 per cent of volunteers who needed treatment.
“The number of aggressive prostate cancers missed by PSA highlights the importance of ramping up our research efforts into alternative ways to screen for prostate cancer. Unfortunately, men can often be put off from seeking medical advice because they are worried about the need for a rectal examination. This type of screening may encourage more men to have a prostate health check.
Professor Hashim Ahmed, Chair of NCRI Prostate Group and PROSTAGRAM Principal Investigator
Results of the Prostagram trial were presented at the virtual ASCO Conference 2020. Derek Price is listed at an author of the abstract ‘Population-based prostate cancer screening using a prospective, blinded, paired screen-positive comparison of PSA and fast MRI: The IP1-PROSTAGRAM study’.