DIPPER

While removal of the prostate is an effective treatment for many individuals with prostate cancer, around one third of people will experience return of their cancer (recurrence). Commonly, this is diagnosed when a blood test called prostate specific antigen, or PSA, becomes elevated. Provided there is no spread of cancer seen on scans, a ‘watch and wait’ surveillance approach, or radiotherapy are both reasonable treatment pathways in individuals deemed to be at low risk of further spread.

However, no-one knows yet what is the best treatment in this situation. While radiotherapy can be effective, it can result in side effects, and these can affect quality of life. It might be possible that personalised selection of individuals for surveillance using blood tests and newer imaging tests, such as PSMA PET scans, might identify a group of people who do not need additional radiation or other treatments and might be able to have similar outcomes for the cancers without the side effects. The DIPPER trial will compare cancer control and quality of life outcomes for individuals receiving either radiotherapy or surveillance following recurrence of their cancer after personalised patient selection, utilising the new imaging test and other clinical information.