Last weekend, national media picked up a story that we reported in November about an NHS England scheme trialling a “one-stop-shop” process for diagnosing prostate cancer. The story was picked up from The Daily Mail, who have launched a prostate cancer campaign after being moved by our news that prostate cancer is now the third biggest cancer killer. We explain the technology behind the story.
Under the ‘rapid pathway’ approach, which is being developed in three hospitals across West London, men have an mpMRI scan, get their results and can have any necessary biopsy, using new FUSION technology, in one day, rather than multiple outpatient visits over four to six weeks.
A FUSION biopsy is when a man has his biopsy guided by ultrasound and the image from an mpMRI scan is overlaid on the ultrasound image to make it even more accurate.
It is not currently widely used except in more specialist centres. In time, if it is shown to have more benefit than other ways to use MRI to target biopsies, it may become more common practice.
A trans rectal biopsy or TRUS is done by putting a probe through the rectum so that needles can be inserted into the prostate. Ultrasound is used to guide it. A transperineal biopsy is when a sample is taken by putting a needle through the perineum (the skin between the testicles and the back passage). Both types of biopsy can be done with or without fusion and both can be made more targeted and accurate when guided by a MRI image.
Men, in discussion with their clinician should choose the type of biopsy that is best for them. This decision can be based on the man’s preferences, but also where in the prostate a potential tumour is located. A transperineal biopsy can carry less risk of an infection and be less invasive, however it is a more specialist technique and in many centres, it requires a general anaesthetic.
No. The mpMRI scan can still be used to help guide where the biopsy needle is directed, even when it is not directly fused with the ultrasound scan.
This is an area which is rapidly evolving. As we learn more about the benefits of each technique and improvement and see the results of pilots and trials, we will want to see the best options made as widely implemented as possible so that men can feel the benefits.
Responding to the scheme, our Director of Support and Influencing, Heather Blake, said: “Improvements to diagnosis are crucial if we are to save more lives from prostate cancer. The benefits of having an mpMRI scan before a biopsy represent the biggest leap forward in prostate cancer diagnosis for decades. That is why we have been working with health bodies across the UK to ensure all men with suspected prostate cancer can have access to a more accurate and less invasive diagnosis.
“We are delighted that NHS England is focussing efforts on exploring how mpMRI before prostate biopsy can be implemented to make diagnosis quicker, easier and more efficient, both from the point of view of the men going through it, but also in terms of NHS resources. We want to see all health bodies across the UK provided with investment in the equipment and staffing that is needed to make mpMRI before biopsy available to men, no matter where they live.”
Writing in a blog about the news that prostate cancer is now the third biggest cancer killer, our chief executive, Angela Culhane, previously said: “We want to halve the number of men dying from prostate cancer within ten years, whatever their age, address or background and, in time, for the disease to become a chronic condition rather than a killer. We know that the wheels are already in motion to turn these statistics around. However funding for further research to improve diagnosis is crucial.
“Plans to create an accurate test fit for use as part of a nationwide prostate cancer screening programme and plans for the development of new treatments for advanced prostate cancer are already well underway. But to achieve these aims, we need to increase our investment in research. We’re calling for people to sign up to a March for Men this summer to help raise the funds we desperately need to stop prostate cancer being a killer.”
If you are worried about prostate cancer and have any other questions, you might find it helpful to read our recent article answering the most common prostate cancer questions that callers ask our Specialist Nurses. Or you can speak to our Specialist Nurses on 0800 074 8383.