Prostate Cancer Patients Urged to Avoid Treatment

Daily Telegraph Wednesday January 8th 2014

By Nick Collins

Thousands of prostate cancer patients should avoid immediate treatment and keep their disease under “surveillance” instead, official guidelines state for the first time.

Updated guidance published by the National Institute for Health and care Excellence (Nice) says men with “intermediate” or “low risk” prostate cancer should consider having regular check-ups instead of immediately undergoing radiotherapy or surgery.

   The advice is designed to prevent thousands of men with relatively harmless tumours from needless suffering or side effects as a result of unnecessary treatment.

   Prostate cancer is the most common cancer in men in the UK, with more than 40,0000 cases diagnosed every year, and 11,000 die each year from the disease.

   But prostate cancer can be “slow growing” and many men will have cancer that will not cause them any harm in their lifetime.

   Treatment options, including surgery and radiotherapy, can have “serious side effects”, such as erectile dysfunction and fertility problems. Under the new guidelines about 20percent of patients will be advised to have “active surveillance” instead of treatment, about half of whom may never need to receive treatment or have surgery. The updated guidance sets out a new protocol detailing how men who choose this option should be monitored with blood tests, biopsies and physical examinations, to see how the cancer is developing.

   Prof. Mark Baker, the director of Nice’s Centre for Clinical Practice, said: “Prostate cancer can be very slow growing and while many men will have a cancer that won’t cause them any harm in their lifetime, nearly 10,000 still die every year in England and Wales.

The updated guideline includes a number of new recommendations on the swift diagnosis and treatment of different stages of the disease and a new protocol; for men who choose active surveillance, which involves regular check-ups to see if and how the cancer is developing, rather than radical treatment.

The aim of this Nice guideline is to ensure that excellent treatment is provided for men who will benefit from it”.

Dr John Graham, the chairman of the guideline development group, added: “All treatments for prostate cancer have serious side effects which can affect the quality of life, especially their effects on erectile function and fertility.

This is why it is so important that men are able to understand the treatment options available to them and, with the support of their health care professional, are able to make a choice to suit their individual needs, both clinically and related to their quality of life.”

He added: “it is important that information and support is available and easily accessible to ensure patients can make the most appropriate decision for them on terms of treatment.

This guideline acknowledges that, and makes recommendations about supportive care.”