Following the Health Secretary's welcome announcement of new targets to diagnose all NHS patients suspected of having cancer within 28 days by 2020, we look at what it means for prostate cancer and why the deadline may not benefit all men referred by their GP for the disease.
Over the weekend, Health Secretary Jeremy Hunt announced ambitious new cancer diagnosis targets. Within five years, 95 per cent of patients suspected of having cancer will either be diagnosed or given the all-clear within 28 days of first being referred by a GP. This is really good news for cancer patients and comes hot on the heels of recommendations by the independent Cancer Taskforce in their new Cancer Strategy for England, who say that this could save 11,000 lives per year.
The problem for some men with suspected prostate cancer is that, at the moment, 28 days may not be long enough to navigate the decisions and procedures that can be required for a firm diagnosis of prostate cancer. This is because if a man has a raised PSA and an abnormal Digital Rectal Examination (DRE), he will be referred to a Urologist to decide together whether or not he should have a biopsy. According to the standard procedures, if the biopsy is positive for cancer, he then needs to wait about 4 weeks for his prostate tissue to recover enough to have an MRI scan and possibly other tests, like a bone scan, to determine how serious the cancer is.
Overall, this can mean that even a very efficient system can take over a month to get a firm yes-or-no decision on whether prostate cancer is present and what type of cancer it is. This is why some men with suspected prostate cancer may not benefit from the 28 day deadline.
This just goes to show, once again, how important it is to develop a quicker and more accurate method for early diagnosis of prostate cancer. And there could be a better approach just around the corner.
Clinical trials of promising new diagnostic tools, like multiparametric magnetic resonance imaging (mpMRI) before biopsy, are well underway and have the potential to remove weeks of uncertainty and delay for men with suspected prostate cancer. The PROMIS trial – set to report in the spring of next year – is investigating whether an mpMRI scan can make it clear that a man either doesn’t have cancer or that he’s at very low risk of having aggressive disease so that he can safely avoid a biopsy. We hope PROMIS will also demonstrate how we can make biopsies more accurate for men who do need them.
Although we don’t have the results of this trial yet, we believe that health services across the UK should start planning to make mpMRIs routinely available to men referred for biopsy so they can start getting their ducks in a row now. That way, they can be be ready to go as soon as any positive results are published.
We want all men to benefit from an early cancer diagnosis and we urge all UK governments to make investment available for new diagnostics, like mpMRI, if and when the results show it works.
Both of these changes are really good news for men living with prostate cancer. It will encourage the NHS to make sure that these men aren’t left without the support they need to make sure that side effects of their treatment don’t negatively affect their lives.
We’ve already started thinking about what this might mean for men living with or after prostate cancer, and we hope that our Movember-funded Life after prostate cancer diagnosis research will give us important insights to feed into this measure.
Abiraterone and enzalutamide remain but radium-223 will no longer be available on the NHS – although those currently on treatment will continue. We look at the details of today's decision, why it's happened and what it means for men with prostate cancer.