38 - PROSTATE CANCER - Improving outcomes for prostate cancer patients

Prostate cancer is the most common cancer in men across the United Kingdom, with approximately one in eight men being diagnosed with prostate cancer at some point in their life. Affecting more than 50,000 men every year, it is important to raise awareness of the signs and symptoms to look out for.

The good news is that the number of men having treatment for prostate cancer has increased by more than 25% in England in one year, according to new NHS figures. Almost 4,000 men received prostate cancer treatment in August 2022 (3,898) compared to just over 3,000 in the same month in 2021.

Furthermore, more people than ever before are receiving urological checks – including for prostate cancer – with over 40,000 more between August 2021 and August 2022, compared to the year before (243,043 in the year ending August 2022 compared to 202,252 in the year before).

These statistics are positive – but the post-pandemic increase may not come as a surprise, as at least 14,000 fewer men were diagnosed during the COVID-19 pandemic, with referrals and treatments for prostate cancer dropping between 2019-2021 because men were less likely to visit their GPs and hospitals.

However, the bad news is that despite the increase in figures for men to get checked and treated, there remains a disparity between men being diagnosed – especially at an early stage – with prostate cancer, and the region they live in.

Prostate Cancer UK has recently warned that there is a huge variation in the likelihood of men being diagnosed when it’s too late for a cure. In London, one in eight men with prostate cancer are diagnosed with metastatic disease – which is an advanced prostate cancer where the cancer has spread from the prostate to other parts of the body – rising to more than one in three in Scotland. Wales, Northern Ireland, and the North and Midlands of England are also shown to be badly affected.

Additionally, statistics around later diagnoses were also highlighted in the latest National Prostate Cancer Audit (NPCA), which revealed that men in more deprived areas are more likely to be diagnosed at a later stage, where it is more likely that the cancer is less treatable.

Unlike the female equivalent – breast cancer – there is no automatic screening for prostate cancer. Many men have to request the prostate cancer blood test, or PSA (Prostate Specific Antigen) test, themselves – and in some cases are even advised against doing so.

Also, with many men not experiencing any symptoms, particularly in the early stages, or disregarding them as a sign of getting older, such as a weak bladder or erectile dysfunction, prostate cancer diagnoses can be overlooked – and more needs to be done to change this.

GPs have a vital role to play by proactively engaging with men who have a higher risk, or men that meet the requirements, to ensure they have a PSA test. GPs are the first point of contact for patients to raise any health issues they may be experiencing and an essential component of that support is opening up the dialogue around prostate cancer, from the earliest possible stage.

By having a PSA test, even to monitor the results as a baseline, we can identify men who are potentially at risk earlier – resulting in a longer lifespan with a higher quality of life for patients and a reduction in prostate cancer mortality.

A later diagnosis also often means that men will have fewer viable, less invasive treatment options available to them. As it stands today, not all men have access to the latest biopsy techniques or treatment options (low dose-rate brachytherapy, radiotherapy, radical prostatectomy, hormone treatment), as they too can often be postcode dependent – which in turn, limits men’s lifestyle choices.

Ultimately, patient choice is key, and there is a need for accurate and fair information and option availability – irrespective of location – to enable men to access the support and options they need, from diagnosis to treatment.