After Prostate Cancer UK bombarded the health authority with substantial evidence and demanded changes, NICE announced they will now undertake an exceptional review of their prostate cancer clinical guidelines. Our CEO, Angela Culhane, explains why it will mean life-saving new diagnosis and treatment should reach thousands of men sooner than expected.

8 Nov 2016

I had a piece of fantastic news last week, one of those breakthrough moments that all of us who work in and support the charity sector aim for.

On the surface it may not sound that exciting. The news was that NICE, after undertaking an exceptional review, had agreed to update its guidelines for prostate cancer diagnosis and management ahead of schedule to respond to recent medical research developments in prostate cancer. It may seem like a technicality but it has big implications.

First, it shows that NICE will listen and be flexible when significant new developments are coming along. We have been tracking a number of new areas of prostate cancer research, some of which have not even been published yet, and ensuring our contacts at NICE know about them. We are delighted that they have now agreed with us that there is enough new evidence to update the guidelines. (More about the exciting new research findings later.)

This review will create the route to getting these exciting research developments into clinical practice, and being used in diagnosing and treating all men who need them

Second, it shows that prostate cancer research is making the kind of rapid steps forward that we have been investing in, and pushing for, for years now. It’s a great boost to see these advances close to reaching men and this will help spur us on in our work to achieve many more leaps forward like this.

Third, and maybe most important, it creates the route to getting these exciting research developments into clinical practice, and being used in diagnosing and treating all men who need them. NICE guidelines are the practice standard for all NHS providers in England. There is little point in Prostate Cancer UK and others investing our funds in research if the results aren’t going to be used in practice, so getting these findings into NICE-endorsed guidelines is a critical step.

The areas that will be covered by this review include the potential for a huge step forward in diagnosis (the use of multiparametric MRI scanning before biopsy), radiotherapy treatment (the outcome of the CHHiP trial, which demonstrates an improved approach through more intense, but shorter treatments), and chemotherapy (the use of docetaxel earlier in the treatment pathway for both metastatic and locally advanced prostate cancer). Not forgetting ProtecT, which provides men with localised disease with evidence of the survival outcomes possible if they choose active surveillance, compared to more radical treatments.

All these are big changes which, if they make it into the updated guidelines in the way we want, will transform the diagnosis and treatment outcomes of men with, or at risk of, prostate cancer and give men a better chance of living longer. We will be continuing to keep a close eye on the progress and results of the NICE review to make sure the updated guidelines deliver these results.

The guidelines aren’t legally binding, so we need to alert commissioners and health care professionals and ensure they are taken on board as quickly as possible

And there is another key aspect to these changes. I pointed out in my last blog how important it will be to look at the long term benefits of changes in practice in a cash-strapped NHS, where resource for driving through changes is stretched. The developments that NICE are now reviewing for the guidelines are likely to be cost-effective over relatively short timescales, creating a win-win for men and for the public purse.

Of course, there is still plenty to do to ensure these valuable new developments reach men in the clinic. NICE guidelines only apply directly in England, so we will continue working with the devolved administrations of Scotland, Wales and Northern Ireland to make sure that parallel changes are happening for men across the UK. The guidelines also aren’t legally binding, so we need to set to work alerting commissioners and health care professionals treating men with prostate cancer to what’s new in the guidelines, and ensure that they are taken on board as quickly as possible.

Sometimes it’s so frustrating to have to wait for grindingly slow progress from the lab to the clinic. Patience is not my greatest virtue, especially when I meet people day in day out whose lives are so blighted by prostate cancer here and now. The war against this disease is still a long way from being won.

But slashing two years off the scheduled review date for these guidelines is an important victory and will provide additional lifelines for thousands of men each year. I’m proud of the part we played and will continue to play in getting prostate cancer up the agenda, and ultimately in taming this dreadful disease.

This blog first appeared on the Huffington Post website.

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