Scientists have discovered that routine scans taken during prostate cancer radiotherapy may do more than just help guide treatment.
These daily scans, which are already used to position patients correctly for each session, could also be used to predict and possibly reduce side effects like rectal bleeding. This finding could lead to more personalized care for men undergoing this common treatment.
The research, published in the journal Physics and Imaging in Radiation Oncology, was led by a team from the University of Cambridge and The Christie NHS Foundation Trust, with additional contributions from the University of Edinburgh.
Prostate cancer is often treated with radiotherapy, which is highly effective in destroying cancer cells.
However, because the prostate is close to the rectum and other healthy tissues, a small amount of radiation can sometimes affect those nearby areas. This may lead to unwanted side effects, such as rectal bleeding, which can negatively impact a patient’s quality of life.
Currently, radiotherapy treatment plans are usually made at the beginning and followed throughout the course of treatment. Adaptive radiotherapy is a newer approach that updates the treatment plan based on changes in the patient’s body during treatment.
But so far, decisions about when to adjust treatment don’t take into account subtle patterns in the tissue that might predict side effects.
To explore this idea, the researchers looked at scans from 187 men receiving radiotherapy for prostate cancer. They used artificial intelligence (AI) to analyze the scans and look for early warning signs of rectal bleeding.
These scans were originally taken just to help position the patient each day, but they also captured detailed information about how tissues in the body were changing over time.
The AI software looked at what are called “radiomic features”—detailed patterns in the scans that can’t be seen by the human eye.
Surprisingly, the team found that even a single scan taken just one week into treatment could help predict whether a patient would develop rectal bleeding in the future. Using data from the first three weeks of treatment gave the most accurate prediction.
This means doctors might be able to spot problems early—before symptoms start—and adjust the treatment to reduce harm while still fighting the cancer effectively. It could allow for more personalized care, where each patient’s plan is adjusted based on how their body responds to the radiation.
While the idea is exciting, the researchers say it will take time to put this into regular use. Larger studies and more automation are needed to confirm the results and make the system easy to use in busy hospitals.
Dr. Zhuolin Yang from the University of Edinburgh said that this shows how the data already collected during treatment could be used in smarter ways, without needing new scans or extra equipment. Professor Bill Nailon added that this study is a proof-of-concept showing the potential of this approach.
Dr. Hayley Luxton from Prostate Cancer UK said that this research could eventually make radiotherapy safer and better for many men. Even though more work is needed, this is a big step forward in using everyday tools to improve cancer care.
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