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Taking Part in the Follow up phase

Further funding has now been granted for the Follow up phase of the study and It is intended that all men are followed up for 10-15 years. The average age of men in the study is now 62 years, ranging from 49 – 78 years.

Over 540 men have had each of the treatments offered by the study: active monitoring, surgery and radiotherapy, all of which are currently used in the NHS.

Follow-up process

•  Following your treatment you will be invited to attend an annual review with a research nurse at your local ProtecT centre to see how you are getting on.

•  You will also receive annual questionnaires, following the initial 6-month questionnaire.

•  It is very important that you continue to complete these questionnaires and attend the reviews, even if you believe nothing has changed over the last 12 months.

The questionnaire data collected are only used by the ProtecT research team and will not be passed on to your GP or anyone else without your consent.

Participants who move within the UK may find that they are now closer to one of the other nine centres, if this is the case you may be able to attend follow up appointments at the new centre, some people are already successfully doing this. It is very important that you let us know your new address. This is so that we can keep in touch with you during the course of the study.

Please tell your ProtecT research nurse when you attend for your appointment or contact them on the above telephone numbers or write to:

The ProtecT Study, Canynge Hall, University of Bristol, 39 Whatley Road, Bristol BS8 2PS You can contact the lead research nurse at your local centre:

Birmingham: Pauline Thompson (0121 627 2992)
Bristol: Lynne Bradshaw and Tricia O’Sullivan (0117 323 5050 ext 2690)
Cambridge: Phillipa Herbert (01223 596 225)
Cardiff: Sarah Tidball (02920 746 501)
Edinburgh: Norma Lyons (0131 537 2433)
Leeds: Debbie Cooper (0113 206 5491)
Leicester: Sue Bonnington (0116 258 8316)
Newcastle: Teresa Lennon (0191 223 1461)
Sheffield: Joanne Howson (0114 271 2791)

ProtecT Lead Nuses - September 2010

As the follow up data forms a crucial part of the ProtecT study, your information is very important to us and we are very keen for you to keep in touch and let us know should your contact details change. Remember moving abroad or away from your local area does not necessarily prevent you from taking part in the study.

Why do we ask for the same information each year?

Your health and feelings may change gradually over several years and this information is very important for comparing the treatments fairly over time. Only by collecting the information for several years would we be able to determine these types of changes which could be useful for determining the best treatment for prostate cancer.

New Research relating to the ProtecT study

Researching the role of folate and vitamin B12 in prostate cancer

The blood samples from the ProtecT study have been used by researchers at the University of Bristol to investigate whether folate and vitamin B12 are related to prostate cancer risk. This is an important research question for two reasons. Firstly, if we were to find that folate and vitamin B12 reduced the risk of prostate cancer, men could be advised to modify their diets; for example, by eating more green leafy vegetables, or by taking folic acid and vitamin B12 supplements. Secondly, if we were to find that folate and vitamin B12 increased the risk of prostate cancer, scientists could advise governments against mandatory fortification of foodstuffs (such as flour) with folic acid and vitamin B12.
Investigating the role of folate and vitamin B12 also allows us to understand the mechanisms underlying the initiation and progression of prostate cancer. For example, one theory is that low levels of folate could increase the risk of a tumour beginning to grow (initiation), but high levels of folate could make an established tumour grow more quickly (progression). Researchers measured levels of folate and vitamin B12 in blood samples from men in the ProtecT study, comparing levels in men diagnosed with prostate cancer against those in men who had low PSA levels or negative biopsies. Preliminary results show that higher levels of vitamin B12, but not of folate, were associated with increased risk of prostate cancer. It is too early to say whether vitamin B12 is harmful, because the higher levels of vitamin B12 in men with prostate cancer could be caused by the prostate tumour (instead of the higher levels of vitamin B12 causing the prostate tumour). So, further research is needed, but the ProtecT study has already made an important contribution to our understanding of the role of these two vitamins in relation to prostate cancer.

Simon Collin, Research Associate University of Bristol

Pubmed link to paper

Recent publications from the ProtecT and ProMPT studies

Information from the questionnaires asking about diet and lifestyle has been published in several papers over the last year. Researchers at Cambridge University led by Professor Ros Eeles have identified new genetic variants which contribute towards the risk of prostate cancer (Identification of new genetic risk factors for prostate cancer, Asian Journal of Andrology, 2009, 11: 49-55, Michelle Guy et al.). It is possible in the longer term that these genetic variants could be developed to form a new test for prostate cancer.

Ms Becky Gilbert at the University of Bristol working with the ProtecT team has analysed the information on exposure to sunlight and the risk of prostate cancer using the questionnaire information. There was no strong link between the amount of sun exposure and prostate cancer risk. It was thought there may be a link through the Vitamin D pathway as sunlight is known to stimulate production of this vitamin (Life course sun exposure and risk of prostate cancer: population-based nested case-control study (ProtecT), International Journal of Cancer, 2009, 125: 1414-1423, R Gilbert; C Metcalfe; S Oliver; D Whiteman; C Bain; A Ness; J Donovan; F Hamdy; D Neal; J A Lane; R Martin).