Hospitals are increasingly using advanced techniques to diagnose and treat men with prostate cancer.
The first report of the National Prostate Cancer Audit (NPCA) was published on the 10th November. The audit looks at whether NHS services in England and Wales for men diagnosed with prostate cancer meet recommended standards.
Prostate cancer is the most frequently diagnosed cancer in men and the third most common cause of cancer-related mortality in the United Kingdom, with about 40,000 new cases each year resulting in 10,000 deaths.
In its first year, the NPCA investigated how prostate cancer services are organised and delivered by NHS providers in England and Wales. The availability of diagnostic, staging and therapeutic facilities was examined.
The report found that modern imaging techniques are being introduced so that better decisions about the most appropriate treatment can be made. For example, 75% of hospitals in England and 60% in Wales reported that they provide multiparametric MRI, an imaging technique with which prostate cancer can be better detected and localised than with conventional techniques.
NHS hospitals are also using innovative surgical techniques. A total of 26 NHS prostate cancer centres in England and one in Wales now offer robot-assisted laparoscopic prostatectomy. With this technique, surgeons can remove the prostate cancer while sparing as much of the surrounding tissues as possible, reducing the risk of impotence and urinary incontinence.
There is also significant progress in the uptake of new radiotherapy techniques. Up to 91% of English radiotherapy centres and all Welsh centres are providing intensity modulated radiotherapy – a technique developed to better focus the radiation to the shape of the prostate cancer. Furthermore, 20% of English centres are providing high-dose brachytherapy – a technique used to treat men with more advanced prostate cancer.
However, the report also highlights room for improvement. All hospitals in England and Wales provide personal support for men diagnosed with prostate cancer, but only 50% in England and 60% in Wales can provide all support services that men may need (ranging from practical support, advice on sexual and continence problems to psychological counselling).
Professor Noel Clarke, NPCA Urological Clinical Lead, representing BAUS, said:
“The National Prostate Cancer Audit will help us to monitor how men with this very serious condition are being treated. It will improve our current standards of care and facilitate the development of better means for diagnosis, treatment and support of patients and their families.
Dr Heather Payne, NPCA Oncological Clinical Lead, representing BUG, said:
“The National Prostate Cancer Audit is an important piece of work that gives us a unique insight into the current management of prostate cancer from the perspectives of the multidisciplinary team but more importantly from patients. For the first time, we will have national data on the courses of radiotherapy that men with prostate cancer receive.
Dr Jem Rashbass, National Director for Disease Registration Public Health England, said:
“The National Prostate Cancer Audit is the first national cancer audit to use the National Cancer Registration System to collect data. This system uses data collected directly from clinical teams as they treat patients. It sets a new benchmark for cancer audits in England.
Professor Jan van der Meulen, NPCA Methodological Lead, said:
“For the National Prostate Cancer Audit, we use as much as possible existing electronic data. In this way, we are able to look in great detail at the care that is currently provided to men with prostate cancer in the NHS while keeping the burden on hospital staff involved in collecting data to a minimum.
In April 2014, the audit started collecting detailed clinical information about the care that is provided to each man diagnosed with prostate cancer in England and Wales. This will produce a detailed database that will help NHS hospitals to evaluate their services. The NPCA will continue for a minimum of five years.
The NPCA is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit Programme in response to the need for better information about the quality of prostate cancer services in England and Wales.
The audit is based in the Clinical Effectiveness Unit (CEU) at the Royal College of Surgeons of England (RCS) and is led by clinical experts from the British Association of Urological Surgeons (BAUS) and the British Uro-Oncology Group (BUG). The National Cancer Registration Service (NCRS) manages the data collection in England and Public Health Wales does the same in Wales.