New guidance from NICE on prostate cancer has recommended active surveillance for the first time, for men with the low-risk localised form of the disease. Previously men with such a diagnosis would have been offered a choice of a radical prostatectomy (to remove the gland and surrounding tissues) or radical radiotherapy – both of which come with distressing side effects but have been shown to cut the risks of the disease spreading to other areas of the body.
But new evidence presented by NICE has shown that active surveillance, the “watch and wait” approach of having regular blood tests and scans to see if the cancer develops, offers the same 10-year survival outcomes as the more radical treatments. The new guidance could affect almost 8,000 of the 47,000 men diagnosed annually with the disease.
Describing the development as ‘great news’, Heather Blake, director of support and influencing at the charity Prostate Cancer UK, said: ‘This could potentially provide thousands of men with the opportunity to safely delay or avoid radical treatment and its associated side effects.
‘What is crucial now is that active surveillance is consistently delivered to a high standard across the UK alongside the personalised information and support men need to confidently choose this approach and benefit from it for as long as possible.’
Dr Sam Merriel, GP and lead author of the new guidelines, stressed the need for ‘emotional and psychological support’ for men faced with the choice.
‘Despite the potential benefits for men, choosing active surveillance over radical treatment is not necessarily an easy decision as it goes against the natural instinct of wanting to get rid of the cancer immediately,’ he said.
Elsewhere the guidance recommended that all men suspected of having the disease should be offered an MRI scan before a biopsy. Professoe Mark Emberton, a prostate cancer specialist at University College London, described the decision as ‘a landmark’, saying: ‘The UK is the first country in the world to formally recommend MRI scans for prostate cancer.’
Prostate cancer remains the most common form of cancer in men, with 11,500 men dying of it every year. Approximately 400,000 men are living with or after the disease in the UK.