By Jessica Dickens | Contributor
Prostate cancer is the most common cancer in men in the UK, with 40,000 new cases annually. The prostate gland is a walnut-sized gland in men found just below the bladder and in front of the rectum which develops into cancer if the cells grow uncontrollably. The cause of prostate cancer is unclear but its risk factors include age, race, family history and obesity. Prostate cancer usually grows slowly, but some types can be aggressive and also spread quickly, which highlights the importance of early detection. If caught early, it may be confined to the prostate gland, which increases the chances of successfully treating it.
A new staging system, called STAR-CAP, for non-metastatic prostate cancer, produced by a team of researchers at the University of Michigan Rogel Cancer Center, shows great promise in determining the treatment outcomes for patients with prostate cancer than previously used methods. The study was published in JAMA Oncology and uses data from a large sample size of patients. 
The most common system used to stage prostate cancer is the Gleason grading system, where tissues are graded from 1 to 5; 1 being normal tissue, and 5 being a highly aggressive, high-risk form of prostate cancer. A ÔÇÿscoreÔÇÖ is produced from the addition of the two most common numbers of the biopsy sample, this score will then be placed into a risk category of low, intermediate, or high. This method used to predict treatment decisions is based on a ÔÇ£fairly blunt and imprecise system”, according to the studyÔÇÖs co-senior author Daniel Spratt, M.D.,Research Professor of Radiation Oncology at Michigan Medicine.┬á
When using the new system proposed by the study, it was found that several patients were not as advanced in the stages of cancer as previously categorised. The co-author of the study, Robert Dess, M.D. who is an assistant professor of radiation oncology at Michigan Medicine emphasises that,
“This is the kind of information that can give patients and doctors more confidence when discussing treatment options and expected outcomes,”┬á
In previous years, the American Joint Committee on Cancer (AJCC) also used another staging system using models to stage prostate cancer. However, as none of the models met the conditions for this system the researchers decided to introduce a new staging system. Daniel Spratt explains,
“None of the previous models evaluated met the criteria, so none of them could be used. So we said, ‘Well, let’s make one.’ We wanted it to be transparent, robust and validated, so that we can start moving closer to communicate using a common staging system, similar to other cancers.ÔÇØ
Clinicians and scientists at the University of Michigan Rogel Cancer Center carried out a 25 year long study to produce a pre-treatment clinical prognostic stage group system for non-metastatic prostate cancer that has demonstrated consistent interpretation of results and can be used all over the world. Furthermore, the study also showed that it is better than the previously used system by the AJCC.
The new proposed system is called STAR-CAP, a points based system produced using the variables analysed in the study, which then assigns patients to a particular stage, from stage 1 to stage 3, with each stage split into substages of A, B and C. The researchers predicted 10-year prostate cancer-specific mortality for the 9 score groups. Owing to the study, Robert Dess is optimistic for the future treatment for prostate cancer:
“We know that some of the newest tools that we have that are just coming online like genomics or molecular imaging may improve upon this system, but we wanted to create the best, most widely accessible model based on the data we currently have — understanding that new tools may help us develop even better models in the future,”┬á
STAR-CAP is a robust, transparent and validated system that has already been made available via a web-based app for clinicians and researchers to utilise. The work done by these researchers has already tremendously helped improve clinical practice for the treatment of prostate cancer as it is now available worldwide for use in prostate cancer staging. 
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