Government announces funding targeted at earlier prostate cancer diagnosis and treatment

Posted: 10/04/2018

Prostate cancer is a disease in which malignant cancer cells form in the tissues of the prostate, a gland in the male reproductive system which lies just below the bladder and in front of the rectum.

In the UK, about one in eight men will suffer from prostate cancer at some point in their life. Each year approximately 47,000 men are diagnosed with the disease and 11,000 men die as a result.

Diagnosis of prostrate cancer usually comes at a point in time when the tumour has already grown to a considerable size. This is because prostate cancer itself does not normally cause physical symptoms until the malignancy has grown large enough to put pressure on the urethra, which results in problems associated with urination. However, late diagnosis also occurs because there is no formal screening for prostate cancer and the traditional method of detection, known as a prostate specific antigen (PSA) blood test, is an inadequate diagnostic tool. This inadequacy is particularly stark when comparing statistics for late diagnosis with those of breast cancer cases. In total 40 per cent of prostate cancer cases are diagnosed at a late stage compared with 13 per cent of breast cancers.

There are various reasons to explain why the PSA test is inadequate:

• it requires the patient to voluntarily attend his GP and is only usually performed routinely in men over 50 years of age;
• it is not precise. A raised PSA level in the blood can be a signal of prostate cancer, but sometimes is not. Patients who have a raised PSA because of another cause, such as an infection, may be subjected to intrusive biopsies only then to find out that they do not have a malignancy;
• it does not differentiate between a form of disease that will rapidly grow and could be lethal and those tumours which are slow growing and may not affect the patient’s long-term health. Therefore all men with an indication for prostate cancer are referred for further investigations along the same pathway; in some cases more urgency is required.

It is well understood that early diagnosis and treatment is key to the patient experiencing a better outcome. The later the diagnosis, the more likely it is that the tumour will have grown to a size where it will have to be removed surgically. This puts the patient at risk of long-term (sometimes permanent) symptoms of incontinence and impotence. If the disease can be detected earlier, however, non-invasive therapies may be offered or, if surgery is needed it can be performed in such a way to protect the nerves and reduce the risk of post-operative problems.

As a result of relatively high levels of late prostate cancer diagnosis, campaigners have been calling for more funding and a formal prostate cancer screening programme. Due to the fact that prostate cancer has recently overtaken breast cancer as the third biggest cancer killer in the UK, the Prime Minister is now set to announce a new drive against prostate cancer. She is expected to confirm £75 million in funding for research that will recruit 40,000 men into clinical trials. It is hoped that this will lead to a new screening programme which can be used in the future for better and earlier diagnosis and treatment of the disease. The new funding will be channelled through the National Institute for Health Research (NIHR) clinical research network, which will work with NHS trusts to investigate and determine the best method for screening and detecting early cancers with the aim of improving diagnoses and care in the future.

Arran Macleod, an associate in the clinical negligence team at Penningtons Manches LLP, said: “Many hospitals already utilise MRI scans due to their now proven diagnostic ability but we are pleased to see that prostate cancer is now being acknowledged as a real threat to male mortality. It is encouraging that the Government is to provide significant funding to research the best methods to diagnose and treat prostate cancer. 

“In our work we often see the physical and emotional harm suffered by patients whose prostate cancer has been under-diagnosed and under-treated, diagnosed later than it should have been, or missed completely. Our team therefore welcomes the new funding and research that will be undertaken by the NIHR, which should improve the timing and accuracy of diagnosis and, ultimately, enhance patient safety.”

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