Prostate cancer treatment: symptoms to look out for and what are new detection tools given approval on NHS
The National Institute for Health and Care Excellence has approved four new biopsy devices which result in fewer cases of infection and sepsis
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There is no single, definitive test for prostate cancer and in some instances, the current tests used to confirm a diagnosis can carry a risk of infection.
The National Institute for Health and Care Excellence (Nice) has now given approval for four tests for NHS use which carry a lower risk of infection.
How is prostate cancer detected?
Men who are suspected of having prostate cancer are currently asked to provide a urine sample to check for infection, and a blood sample to test the level of a prostate-specific antigen (PSA) - this is known as PSA testing.
A GP may also carry out a digital rectal examination.
The results of all three of these tests will be considered, along with a person’s age, family history and ethnic group, to determine the risk of having prostate cancer.
Those who have a raised PSA level may be referred to hospital for an MRI scan of their prostate. If this shows a problem, patients will then be offered a biopsy to confirm the result.
There are two methods for performing biopsy, a transrectal ultrasound guided (TRUS) biopsy and a local anaesthetic transperineal (LATP) biopsy.
TRUS can be associated with serious infections which sometimes require hospital admission and antibiotics, according to Nice.
What new tests have been approved for use?
Nice has approved four new LATP biopsy devices for use in the NHS in England as options for helping to diagnose prostate cancer.
The body said that the rates of detection of cancer do not differ between each type of biopsy and that the LATP is more cost effective for the NHS.
Dr Mark Kroese, chairman of the Nice diagnostics advisory committee, said: “People with suspected prostate cancer can now have a different option when it comes to having a biopsy.
“The committee heard from patient experts that there are concerns they are not getting clear and accurate information about having a biopsy, they are worried about an associated risk of infection, and the severity and duration of side effects.
“LATP using a freehand needle positioning device for taking a prostate biopsy should reduce unnecessary infections and therefore antibiotic use, benefiting both the patient and the NHS.”
Chiara De Biase, director of support and influencing at Prostate Cancer UK added: “LATP biopsies have been available on the NHS for several years and are a quick and cost-effective way of detecting prostate cancer.
“Most importantly, however, they result in fewer cases of infection and sepsis than more traditional TRUS biopsies, and ultimately cause less harm to men.”
What are the symptoms of prostate cancer?
Symptoms of prostate cancer do not usually appear until the cancer has grown large enough to put pressure on the tube that carries urine from the bladder out of the penis (urethra).
Commons symptoms to look for include:
- needing to pee more frequently, often during the night
- needing to rush to the toilet
- difficulty in starting to pee
- straining or taking a long time while peeing
- weak flow
- feeling that your bladder has not emptied fully
- blood in urine or blood in semen
These symptoms do not necessarily mean you have prostate cancer. Many men’s prostates get larger as they get older due to a non-cancerous condition called benign prostate enlargement.
Warning signs that the cancer may have spread include bone and back pain, loss of appetite, pain in the testicles and unintentional weight loss.
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