At this year's annual meeting of the British Association of Urological Surgeons, it was the exciting potential of mpMRI scans before a biopsy that had attendees buzzing. We were there to help make the case for the new diagnostic tool and our Change Delivery Officer, Jade Fairfax, reports on how it led to a commitment from urologists and BAUS to roll out mpMRI across the UK.
Last week, we attended the British Association of Urological Surgeons (BAUS) annual scientific meeting in Liverpool. This event is an opportunity for urologists to learn about and discuss upcoming clinical developments and to share good practice. It's always important for Prostate Cancer UK to have a presence at this event, not only to meet urologists who are leading change and improvement in prostate cancer care, but to make sure we are at the heart of the research and scientific communities involved in prostate disease and can inform and influence practice to improve outcomes for men.
Throughout the conference, our patient videos were played, giving urologists a unique insight into their patients' experiences. Our annual evening reception was very well attended, with over 100 guests hearing more about the importance of the patient voice from Duncan Summerton, Honorary Secretary of BAUS, as well as one of our Patients as Educators volunteers. Our CEO, Angela Culhane, spoke about some of our change priorities that will help us achieve our goal of taming prostate cancer in ten years, encouraging guests to get involved.
And Tasia Malinowski, our Health & Social Care Professionals Programme Manager, also presented during the conference, sharing case studies of how professionals that we fund are supporting men to manage their side effects and have a better quality of life.
One of the hottest topics in prostate cancer at the conference was diagnosis and the potential merits of giving men with a high PSA a multi parametric MRI scan before they go on to have a biopsy.
Over 47,000 men are diagnosed with prostate cancer each year in the UK, and many more than that undergo the discomfort – and sometimes infections – that result from a trans-rectal ultrasound (TRUS) biopsy. The early results from the PROMIS trial (Prostate MRI imaging study), announced at the American Society of Clinical Oncologists conference earlier this month, clearly showed that mpMRI has the potential to safely reduce the number of men with a raised PSA level who go on to have a biopsy.
This is likely to have a follow on benefit of reducing the number of non-significant cancers being treated, as well as the number of men experiencing infections as a result of biopsy.
On day three of the BAUS conference, Mark Emberton and the team leading the PROMIS trial at University College London (UCL) presented the findings again to a packed room. There were a lot of questions from the floor about the trial and the level of interest from the urologists was understandable. Introducing mpMRI into the diagnostic pathway will bring a radical step-change to current practice. It has to be underpinned by urologists’ having complete confidence in the scans taken and the way they are interpreted if they are to be able to safely rule some men out of a biopsy.
We recognise that urologists need assurances that a prostate MRI scan before a biopsy will deliver the best outcomes for men. That’s why the Prostate Cancer UK satellite session we held focused on solving the potential challenges of delivering this innovative pre-diagnostic tool. Our trustee, Roger Kirby, chaired the session, leading a panel of experts from across the field, including: Hash Ahmed, MRC Clinician Scientist and Reader in Urology at UCL; William Cross, Consultant Urological Surgeon at Leeds Teaching Hospitals NHS Trust; Philip Haslam, Consultant Interventional and Uro-radiologist; and Sue Maughn, Cancer Commissioning Lead at City and Hackney CCG.
Heather Blake, our Director of Support and Influencing, was also on the panel. She outlined how Prostate Cancer UK wants the benefits of a prostate MRI before biopsy to become a reality for all men, wherever they live in the UK. But she also explained what groundwork needs to be laid in advance – groundwork that Prostate Cancer UK is at the forefront of putting in place.
We want radiologists to have the training they need in order to be confident at interpreting mpMRI scans so that urologists can safely rule some men out of a biopsy. We also want these scans audited so that processes to ensure quality are in place. There needs to be sufficient scanner capacity too, with these machines calibrated correctly. She also outlined what Prostate Cancer UK is doing in order to make this happen, from developing a Royal College of Radiologists’ training programme and a specification check-list for Clinical Commissioning Groups, to drawing up a clinical consensus for roll out requirements, including quality assurance and audit.
We’ll also work to make sure that across the UK, there is the scanner capacity in place so that they can be accessed by men at a distance that they think is reasonable to travel for a specialist scan.
During the session, it was extremely interesting to hear urologists' views and concerns, particularly having had time to reflect on Mark Emberton’s presentation. The general feeling in the room was very positive. They agreed mpMRI could benefit men and want to see it happen, agreeing this needs to be in a controlled and consistent manner. It was also great to see acknowledgement of the key role that Prostate Cancer UK is playing and to receive a commitment from BAUS and the urologist community to join us in making sure that roll out of pre-biopsy mp-MRI is made possible within the correct parameters.
It is now likely to be a matter of months until the PROMIS research paper is published. Prostate Cancer UK will continue to work to make sure that when it does, the roll out of this innovative pre-diagnostic technique delivers the best outcomes for men.