Managing prostate cancer in an era of delayed diagnoses

Two reports were released this week which present the challenging healthcare landscape facing those with suspected cancer.

The House of Commons Health Committee report on cancer services revealed that  progress in the early diagnosis of cancer in the NHS has been stalled. Based on data up to 2019, the report showed that only 54% of cases are diagnosed at stages one and two, considered vital for increasing the chances of survival. It pointed out that the NHS aim is to diagnose 75% of cases in the early stages, but there has been no improvement in six years. This situation is based on pre-pandemic data, and many believe the situation to be far worse than reported by the Commons.

According to Gordon Wishart, professor of cancer surgery at Anglia Ruskin University and Chief Medical Officer at Check4Cancer, “Analysis of 2019-2020 data from the South East London Cancer Alliance, has confirmed an overall 3.9% increase in advanced cancer stage presentation (Stages 3 and 4) and, for prostate cancer there was a 3.8% increase in patients presenting with Stage 4 disease. This stage shift for prostate cancer is likely to increase when further data from 2020-2021 is analysed”.

The report’s findings have implications for patients and providers alike. As prostate cancer campaigner and patient advocate Andrew Gabriel commented, “in addition to the lives unnecessarily cut short, families broken by early loss of a member, and reduced quality of life, failing to cure a prostate cancer patient costs 10-20 times more than curing them by catching it earlier. That’s a financial time bomb for the NHS”

Cancer campaigner Chris Lewis offers this advice to those concerned by the report’s findings: “Prostate cancer is particularly difficult to navigate at the best of times. So many options and choices. But now, like many other tumour types the landscape has changed. Obtaining timely treatments etc is becoming more challenging. I would advise every patient to be as proactive in their care as they can. Don’t sit back and wait for things to happen. Push for everything you require!”

Professor Wishart adds “there has never been a better time to consider prostate screening using a PSA blood test. If your PSA is high for your age, a prostate MRI scan will help decide whether a prostate biopsy is required or not. If you are unable to get a PSA test from a GP then, you can get a finger-prick PSA blood test sent to your home so there is no need to attend a clinic. You can get further details about PSA home testing by clicking here

The second report giving cause for concern was published in the Lancet and showed that over a third of cancer patients in England were diagnosed not through GP referral but in A&E departments. Comparing the UK with other countries, It further revealed that countries with higher levels of emergency cancer presentations have lower survival rates.

The study found that those aged 75 and over were more likely to be diagnosed in an emergency, as were those whose cancer was advanced. Emergency diagnoses also resulted in a twofold higher risk of dying in the next 12 months compared with people who were diagnosed at other times.

We urge all men over 50 to request a PSA test from their GP, and if that is unsuccessful, to seek out a hospital-based self-referral unit like the one at Southampton or mobile prostate screening service like the one recently launched by the Royal Marsden. And if these options prove difficult to order a home-based PSA testing kit.  

We will continue to campaign to make PSA tests available and accessible to all men over 50.

Do you have a story to share about screening for prostate cancer or encountering obstacles to obtaining a diagnosis? We’d love to hear from you.

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