THE National Institute for Health & Care Excellence (Nice) has issued new guidelines to GPs which concentrate on cancer symptoms with recommendations on urgent referral for specialist investigation.
It is estimated that following these guidelines will save 5,000 lives every year.
UK cancer death rates are considerably worse than those in Europe, particularly for men, who have higher death rates than women. One possible cause for this is delayed diagnosis due to late referral from GPs.
How will this guidance impact upon our most common men’s cancer, prostate cancer (PCa) which currently kills over 11,000 men (second only to lung cancer) every year in the UK?
I suspect none.
Why?
Because by the time PCa causes symptoms (prostate cancer does not have early symptoms) it will usually have spread beyond the prostate gland and such cancers are usually not curable.
To catch cancer while still in the prostate gland means looking for it before symptoms are produced. In other words, screening, using the simple and cheap PSA blood test (Prostate Specific Antigen).
Extensive screening trials across Europe for men aged 50-70 now show a reduction in PCa mortality of up to 42 per cent, though at risk of some unnecessary overtreatment in some men whose cancers would never have caused problems.
The European trials showing the benefit of lives saved outweighs the risk of harm.
In the UK improved diagnostic pathways using second-line markers such as HK2 and MRI prostate scanning are reducing unnecessary biopsies and allowing better visualisation of cancers that do not need treatment.
The multi-disciplinary cancer teams and careful discussion of treatment options with patients greatly reduce the risk of treatment of non-aggressive cancers.
These Nice guidelines will be of little help for men at risk from prostate cancer and therefore, it is up to men themselves from 40 onwards to be aware of their prostate gland and consider the option of a PSA test and help to ‘Save-a-Dad’, especially if it’s you.
Gary Steele MBE
Chairman Leighton Hospital Prostate Cancer Support Group
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