The National Institute for Health and Care Excellence (NICE) is updating clinical guideline on the diagnosis and treatment prostate cancer.
As part of this process, draft recommendations have been published on the NICE website for public consultation.
Since the original recommendations were published in 2008, a number of new treatments have been licensed for the management of hormone-relapsed metastatic prostate cancer.
There is also more information on the best way to diagnose and ‘stage' the disease, as well as how best to manage the side effects of radical treatment.
Professor Mark Baker, Centre for Clinical Practice Director at NICE, said: "Prostate cancer is a common and serious disease, with around 35,000 men diagnosed each year. However, it can be very slow growing and may not need treating for many years.
"The aim of this NICE clinical guideline is to ensure that excellent treatment is provided for men who will benefit from it, and avoiding or postponing potentially unhelpful procedures for those who won't benefit."
New provisional recommendations include:
• Diagnosis - Magnetic resonance imaging (MRI): Consider multiparametric MRI (using T2- and diffusion-weighted imaging) for men with a negative transrectal ultrasound 10-12 core biopsy to determine whether another biopsy is needed.
• Low-risk localised prostate cancer: Offer active surveillance as an option to men with low-risk localised prostate cancer for whom radical surgery or radiotherapy is suitable.
• Consider using the new protocol for men who have chosen active surveillance.
• Intermediate-risk localised prostate cancer: Consider active surveillance for men with intermediate-risk localised prostate cancer who do not wish to have immediate radical treatment.
• High-risk localised prostate cancer: Offer men with intermediate- and high-risk localised prostate cancer a combination of radical radiotherapy and androgen deprivation therapy, rather than radical radiotherapy or androgen deprivation therapy alone.
• Intermediate- and high-risk localised prostate cancer: Commissioners of urology services should consider providing robotic surgery to treat localised prostate cancer.
• Managing adverse effects of radical treatment - Radiation-induced enteropathy (intestinal injury caused by radiation): Ensure that men with signs or symptoms of radiation-induced enteropathy are offered care from a team of professionals with expertise in radiation-induced enteropathy (who may include oncologists, gastroenterologists, bowel surgeons, dietitians and specialist nurses).
The draft guideline will be available on the NICE website from 16 July 2013, and the consultation closes on 10 September 2013.
