Prostate cancer is the most common cancer in males in the UK and its biology is extensively studied. Understanding this fundamental biology drives the development of biomarkers for early detection and new treatments to improve survival for patients. However, when we question the “ground truth” of this underpinning biology, it isn’t always as robust as it seems.

In this lecture, I will describe a personal journey questioning the science of prostate cancer and how this lead my team to establish new descriptions of prostate stem cell biology and the unique insights these now provide into describing mechanisms of carcinogenesis. Similar parallels about the quality of science the informs our evidence based clinical practice will also be described. I will illustrate how my experience with the PHOTO study, the largest surgical trial in bladder cancer in UK history, challenged the status quo and why positive trials don’t always lead to improvement in patient outcomes. The common theme of the lecture will talk of the importance of continuing to question the evidence and that the “long way round” to get the answer is often the right way round.