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Clinically, identifying which clonal lineages and microenvironments within cancerised fields remain indolent versus progress is a major challenge in prostate and bladder cancer. This review examines evidence from key spatial profiling studies to explain how spatial ‘omics’ clarifies genetic, epigenetic, transcriptomic, proteomic, and cellular microenvironments driving progression, while highlighting technological barriers for clinical translation.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/what-spatial-omics-is-teaching-us-about-field-cancerisation-in-prostate-and-bladder-cancer/366549/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/what-spatial-omics-is-teaching-us-about-field-cancerisation-in-prostate-and-bladder-cancer/366549.png","ImageObject",300,407,{"name":92,"@type":93},"Jasmine","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-28","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is field cancerisation and why is it clinically important in prostate and bladder cancer?","Question",{"text":112,"@type":113},"Field cancerisation is the process where groups of cells acquire cancer-associated phenotypic features before transforming into cancer. It is important because distinguishing indolent clonal lineages and microenvironments from those that progress is difficult and impacts surveillance and treatment decisions.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How do spatial omics methods help study field cancerisation?",{"text":117,"@type":113},"Spatial omics techniques enable investigation of genetic, epigenetic, transcriptomic, proteomic, and cellular microenvironments that may transform normal tissue into cancerised fields and then into cancer.",{"name":119,"@type":110,"acceptedAnswer":120},"What are the main challenges preventing broader clinical use of spatial omics for field cancerisation?",{"text":121,"@type":113},"The review concludes that, despite potential for risk stratification and personalised treatment, several technology-related challenges must be overcome before the promise of spatial omics can be fully realised in clinical practice.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},366549,1790574487,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":41},2336478487870,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","BJU Int 2025; 136: 578–589 doi:10.1111/bju.16830  \nReview  \nWhat spatial omics is teaching us about fieldcancerisation in prostate and bladder cancer  \nMatthew H. V. Byrne1, Thineskrishna Anbarasan1, Lisa Browning2†  and Dan J. Woodcock1†  \n1Nuffield Department of Surgical Sciences, University of Oxford, and 2Department of Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK  \n†L. B. and D.J.W. contributed equally as last author.  \nBackground and Objectives  \nField cancerisation is the process that results in a group of cells acquiring some of the phenotypic changes of cancer prior to transformation into cancer. Clinically, an important challenge remains the ability to distinguish clonal lineages and microenvironments within cancerised fields that will remain indolent from those that will progress to malignant transformation. Spatial ‘omics’ can help us investigate genetic, epigenetic, transcriptomic, proteomic, and cellular microenvironments that transform normal cells into a cancerised field, and subsequently into cancer. In this review, we will discuss how spatial omics techniques have expanded our understanding of field cancerisation in prostate and bladder cancer, and the challenges associated with this research.  \nMethods  \nWe identified key articles relating to field cancerisation in bladder and prostate cancer. Special emphasis was placed on studies that used modern spatial profiling technologies and studies that were designed to investigate changes within normal tissue rather than simply using it as a control for tumour tissue.  \nResults  \nSpatial omics research into field cancerisation has identified interesting early findings that have informed our understanding of: transformation of the benign epithelium and mechanisms of intra-prostatic clonal expansion for prostate cancer; clonal expansion within the normal urothelium; mutations that are unique to cancerised fields within the bladder; and how fieldcancerisation may prime the urothelium for cancer transformation.  \nConclusions  \nSpatial omics profiling of field cancerisation can inform risk stratification and personalised treatment options. However, there are a number of challenges associated with the technologies that must be overcome before the potential of spatial omics can be fully realised in clinical practice.  \nKeywords  \nspatial transcriptomics, spatial proteomics, spatial genomics, spatial metabolomics, field cancerisation, field change, field effect, field defect, bladder cancer, prostate cancer  \nIntroduction  \nField cancerisation (also known as field effect, field change, and field defect) refers to the process that results in a group of cells acquiring some of the phenotypic features of cancer, prior to transforming into cancer [1] . Mutagenic insults, microenvironmental changes, and age-related changes may cause field cancerisation [1] . These environmental disturbances induce changes in normal cells, including genomic changes, transient changes such as epigenetic changes [2], and context-specific changes, such as a specific  \ncellular microenvironment [3] . These cancerised cells include histologically normal cells as well as cells with morphological changes such as dysplasia, hyperplasia, or metaplasia [1] . Cancerised cells can clonally expand into a cancerised field through displacement of normal epithelial cells, for example, a monoclonal field may expand after a cancer stem cell has acquired changes that provide a growth or survival advantage [4] . Some diseases have many small clonal populations [5], whereas others demonstrate domination by a limited number of clones [6] . Alternatively, a polyclonal field may develop through multiple exposures to a mutagen and different clones  \n􀀁 2025 The Author(s) .  \n[wileyonlinelibrary.com](wileyonlinelibrary.com) BJU International published by John Wiley & Sons Ltd on behalf of BJU [International. www.bjui.org](International. www.bjui.org)  \nThis is an open access article under the terms of the Creative C","cbCaiat4jyM17Ko1","https://ap.wps.com/l/cbCaiat4jyM17Ko1","pdf",725426,12,"English","# Background and Objectives\n# Methods\n# Results\n# Conclusions","[{\"question\":\"What is field cancerisation and why is it clinically important in prostate and bladder cancer?\",\"answer\":\"Field cancerisation is the process where groups of cells acquire cancer-associated phenotypic features before transforming into cancer. It is important because distinguishing indolent clonal lineages and microenvironments from those that progress is difficult and impacts surveillance and treatment decisions.\"},{\"question\":\"How do spatial omics methods help study field cancerisation?\",\"answer\":\"Spatial omics techniques enable investigation of genetic, epigenetic, transcriptomic, proteomic, and cellular microenvironments that may transform normal tissue into cancerised fields and then into cancer.\"},{\"question\":\"What are the main challenges preventing broader clinical use of spatial omics for field cancerisation?\",\"answer\":\"The review concludes that, despite potential for risk stratification and personalised treatment, several technology-related challenges must be overcome before the promise of spatial omics can be fully realised in clinical practice.\"}]","What spatial omics is teaching us about field cancerisation in prostate and bladder cancer | PDF",1790166062]