NHS launches a 'one-stop' service to diagnose prostate cancer

A ‘one-stop’ service to revolutionise prostate cancer treatment has been launched by the Health Service.

The quick-access programme slashes the time taken for a diagnosis from around six weeks to just days.

Patients have all their tests in one day, rather than several. And doctors use the latest MRI scanners and techniques to search for the disease with far greater accuracy than before.

Doctors hope to test 5,000 men over the next two years in the £1.6million trial. 

Campaigners say it is the biggest leap forward in prostate cancer diagnosis for decades.

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‘Our target waiting times have considerably reduced,’ said Hashim Ahmed, the consultant surgeon in charge of the programme. ‘We are diagnosing men quickly and they are then being treated quickly. They don’t have to come back on multiple visits. We are biopsying fewer patients – and yet we are catching more aggressive cancers.’

Official figures released last month showed that prostate cancer has now become a bigger killer than breast cancer.

Care has improved since the Daily Mail began campaigning for better treatment in 1999 but the advances have been slow compared with other diseases.

The new service means that four in ten patients will be given the all-clear within four hours of walking into hospital and the remainder will get their results within a few more days.

Quick diagnosis can be the difference between life and death: 98 per cent of those who are diagnosed early survive for more than five years. This figure drops to 36 per cent for those who are diagnosed late.

Professor Ahmed, who is based at Imperial College London, said that detection of aggressive cancers increased from 23 per cent to 31 per cent. And a safer biopsy technique reduced rates of infections that can prove fatal.

So far 400 men have been treated as part of the Rapid programme. It was launched at Imperial College’s Charing Cross hospital in west London in September, expanded to Epsom Hospital in Surrey in November and started at St George’s in south London this week.

Doctors in Nottingham are in discussions about launching a similar scheme.

Professor Ahmed will present initial data at the European Association of Urology conference in Copenhagen this month. He believes the approach could form the basis for setting up a national screening programme.

I was very lucky not to have to wait

When Aleksander Jovanovic was referred for prostate testing, he assumed he was in for months of waiting.

‘I have had some experience of this in the past,’ said Mr Jovanovic, 54, a married father of two from west London. ‘But this time, from day one it was very different – I could not believe how organised it was.

Guinea pig: Aleksander Jovanovic

Guinea pig: Aleksander Jovanovic

Guinea pig: Aleksander Jovanovic

‘There was no waiting around, they just took me from tests to results.’ Mr Jovanovic was one of the very first men to go through the new Rapid programme.

He was referred to Imperial College London after an adverse blood test, having a scan then a biopsy in a single day. Within ten days he had the results, showing he had prostate cancer.

He was put on hormone pills to ensure it did not spread and within two months had an operation to remove his prostate.

That was judged to have gone well, and Mr Jovanovic has an appointment later this month to find out whether the cancer has been eradicated.

‘I count myself very lucky,’ said the Serbia-born IT worker.

‘The NHS is now leading the way in ensuring all men get to benefit from this innovation,’ he added.

‘Fast access to high-quality prostate MRI allows many men to avoid invasive biopsies as well as allowing precision biopsy in those men requiring it to find high-risk tumours much earlier.’

Simon Stevens, who is chief executive of NHS England, said: ‘This is an encouraging breakthrough in prostate cancer diagnosis that is genuinely world-leading.

‘While still early days, the potential benefit to men with suspected cancer is significant.’

Early results show that men are diagnosed in an average of 17 days after referral from GP – compared with a national average of 56 days.

For patients who need a biopsy the procedure is much more accurate. Doctors use an MRI scan overlaid against live ultrasound images to take samples from suspicious tissue rather than choosing random locations.

Fewer samples need to be taken, reducing infection rates from 6 per cent to 0.5 per cent. Cases of potentially deadly sepsis fell from around 1 per cent to virtually none.

Heather Blake of Prostate Cancer UK said: ‘Improvements to diagnosis are crucial if we are to save more lives from prostate cancer. The benefits of having a multi-parametric MRI scan before a biopsy represent the biggest leap forward in prostate cancer diagnosis for decades.’

She said the Rapid system would make ‘diagnosis quicker, easier and more efficient, both from the point of view of the men going through it, but also in terms of NHS resources’.

Prostate cancer claims 11,800 lives a year, compared with the 11,400 victims of breast cancer. Experts say late diagnosis causes many needless deaths.

By contrast, screening for breast cancer is routine with middle-aged women invited for scans every three years.

Owen Sharp, of the Movember Foundation for prostate cancer, said: ‘The shocking reality is that over 47,000 are diagnosed with prostate cancer every year, which shows the scale of the problem.

‘The difference between early detection and late detection can be life and death. It is great news that this pilot offers the opportunity for men to get faster diagnosis with a reduced risk of complications. We look forward to this new diagnostic pathway being made available to all men.’

MRI scanners have improved outcomes for men with prostate cancer. A team led by University College London found it correctly diagnosed 97 per cent of aggressive tumours, nearly double the 48 per cent identified with biopsy alone. 

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