Fewer men get unnecessary prostate cancer treatment

Only 8% of men with low-risk prostate cancer received potentially unnecessary radical treatment in 2015–16 compared to 12% in 2014–15, according to the fourth Annual Report of the National Prostate Cancer Audit (NPCA) published by the Royal College of Surgeons.

The audit looked into the proportion of men with low-risk prostate cancer undergoing radical prostate cancer therapy. Those patients that did not go ahead with radical treatment are likely to have had active surveillance. NICE guidance updated in 2015 says that men with low-risk prostate cancer must discuss treatment options, which can include more radical treatments as well as active surveillance and their potential adverse effects.

Professor Noel Clarke, NPCA Urological Clinical Lead, representing The British Association of Urological Surgeons, says: ‘Improved understanding of the behaviour of low-risk prostate cancer has resulted in more men with low-risk, localised prostate cancer being offered the option of active surveillance. However, there will always be patients who prefer to have surgery or radiotherapy straight away and some who have other risk factors which mean intervention treatment is better. Safe-guards should be in place to ensure all men are appropriately counselled on the advantages and disadvantages of active surveillance in this disease setting.’

‘For those patients who do require treatment to cure the disease, the audit has found that there are ongoing improvements in surgical and radiotherapy techniques used to treat prostate cancer which follow the best available international evidence, and patient satisfaction with this is very high.’

Professor Heather Payne, NPCA Oncological Clinical Lead, representing The British Uro-oncology Group (BUG), says: ‘For the first time, we compare the quality of prostate cancer care provided by NHS providers in England identifying any potential outlying performance. The standard of care is increasing year on year and there is little regional variation.’

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