The National Institute for Health and Care Excellence has recommended pre-biopsy mpMRI scans and a host of other improvements to diagnosis and treatments for prostate cancer become standard NHS practice across the UK. While we back the proposals, we're calling for enough scanners and trained staff to deliver them.

Clinicians at Guys Hospital
12 Dec 2018

New guidelines for treating and diagnosing prostate cancer on the NHS have been published for consultation today by the National Institute for Health and Care Excellence (NICE).

The best practice recommendations – which are usually updated every five years to take on board the latest medical advances – include making high-tech mpMRI scans the first course of action for any man suspected of having the disease. The diagnostic technique should prevent thousands of invasive and unnecessary biopsies every year, while also helping clinicians better target any biopsy or subsequent treatment that is needed.

There were also new recommendations for active surveillance, docetaxel chemotherapy, radiotherapy and post-treatment support:

  • All men with low-risk, localised prostate cancer should be offered active surveillance as a treatment option, as well as radiotherapy or prostatectomy, with a compulsory mpMRI scan beforehand.
  • Radiotherapy for localised prostate cancer will be given at a lower dose over a shorter period of time, which was proven in 2016 to provide equal benefit with fewer visits to hospital.
  • Docetaxel chemotherapy will be given to men newly diagnosed with advanced prostate cancer, and considered for men with high-risk locally advanced disease, following the STAMPEDE trial's positive findings in 2015.
  • Men whose PSA is stable after prostate cancer treatment and have no complications should be offered a supported self-management programme – such as the one we've developed and been trialling through our TrueNTH initiative.

Increased scanner capacity, training and workforce vital

"Earlier this year, we found that only 50% of men with suspected prostate cancer across the UK were being offered mpMRI before biopsy to the highest, evidence-based standards," says Heather Blake, our Director of Support and Influencing.

"Now that NICE has endorsed this breakthrough diagnostic technique as being both clinically and cost-effective, there should be no further delay in making sure all men can benefit from the increased accuracy of diagnosis it can provide.

"We’re also pleased to see that active surveillance has been recognised as having equal survival benefit as surgery and radiotherapy for men with low-risk, localised prostate cancer, which should give more men confidence to avoid or delay these more radical treatments and their potential side effects.

"The fact that mpMRI has also been put at the heart of the active surveillance programme again shows recognition of its effectiveness not only in diagnosis, but also in monitoring progression.

"We want to see the new recommendations taken up by commissioners and clinicians in all parts of the country. It’s also vital that all UK cancer strategies ensure there is the increased scanner capacity, training and workforce required to enable all men to benefit from this guidance now and in the future."

NICE's draft guidelines are out for consultation with clinicians and professional bodies until January, and we expect them to be finalised without any major amendments early next year.

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