Latest news with #overtreatment
BBC News
7 days ago
- Health
- BBC News
Men being over-treated for prostate cancer, says charity
The NHS is over-treating men for prostate cancer, a charity says, with around 5,000 a year undergoing treatment for cancers unlikely ever to cause one in four prostate cancers are so slow growing that men can opt for regular monitoring rather than treatment, such as surgery and radiotherapy, which can cause side-effects such as incontinence and erectile dysfunctionOf the 56,000 diagnosed in the UK each year, around 6,500 men opt for this, but an analysis by Prostate Cancer UK said another 5,000 could charity said outdated guidelines were to blame. The National Institute for Health and Care Excellence (NICE), which produces them, said it was reviewing its advice. NICE recommends that monitoring, using blood tests and scans, should be offered to the lowest risk cases, where nine in 10 will have no signs of cancer spreading within five research has suggested this could be extended to the next lowest risk group where eight in 10 men will have no signs of cancer spreading. Evidence gathered by Prostate Cancer UK suggests many hospitals have started offering monitoring to this wider group of patients, but a quarter have to the charity's analysis:in some hospitals in England, 24% of patients who could be monitored, instead undergo treatmentacross the UK, an average of 8% of men who could be monitored are treated instead, amounting to 5,000 a yearSome of this could be down to patient choice – men are generally given the option of treatment even if they are at the charity said if the NHS was more active in offering monitoring it could help strengthen the case for prostate cancer screening, which has gained traction since the diagnosis of Olympic cyclist Sir Chris argument against screening is that the prostate specific antigen (PSA) blood test, used to spot potential signs of the cancer, is unreliable and leads to unnecessary Rylance of Prostate Cancer UK, said: "To reduce the harm caused by prostate cancer and build the foundations for a screening programme, we need to both save lives and prevent unnecessary treatment."One patient who opted for monitoring was Michael Lewis, 63, from the West was diagnosed with prostate cancer in 2020 and, as it was judged low-risk, he opted for monitoring. Four years later tests suggested the cancer was worsening so he had his prostate removed. He said delaying treatment was so valuable."I was able to continue my everyday life with no side effects."NICE said the organisation was reviewing the prostate cancer guidelines and looking to update them."We are committed to ensuring our guidelines continue to reflect the best available evidence and give patients the best possible outcomes," said a spokesman.
The Independent
7 days ago
- Health
- The Independent
Thousands of cancer patients could be undergoing unnecessary overtreatment
Up to 5,000 men in the UK could be undergoing unnecessary overtreatment for prostate cancer annually due to 'outdated' guidelines. Prostate Cancer UK warns that current National Institute of Health and Care Excellence (NICE) guidelines, last updated in 2021, do not account for advances in testing and diagnosis, leading to overtreatment. Overtreatment of slow-growing prostate cancers can result in severe side effects such as erectile dysfunction and incontinence, which could often be avoided with active monitoring. Experts describe a "wild west" or "postcode lottery" in care, with overtreatment rates varying significantly across England and many hospitals developing their own inconsistent guidelines.
The Independent
11-08-2025
- Health
- The Independent
Thousands of men with prostate cancer facing unnecessary overtreatment, experts warn
Up to 5,000 men every year could be facing unnecessary overtreatment for prostate cancer due to 'outdated' guidelines, a charity has warned. Overtreatment of the disease can lead to side effects such as erectile dysfunction or incontinence, according to Prostate Cancer UK. Patients whose cancer is unlikely to progress may only need close monitoring. But experts say out-of-date guidance from the National Institute of Health and Care Excellence (Nice) has created a "wild west" of what is implemented in the NHS. The warning comes as the government is currently awaiting advice on a national screening programme for prostate cancer, which was launched following Sir Chris Hoy 's call for more men to be screened after he revealed in February 2024 that he had been diagnosed with stage four prostate cancer. Around one in four men diagnosed with prostate cancer will have a cancer that is so slow-growing it is unlikely to ever cause them harm. NICE guidance currently only advises active surveillance as the preferred approach for men who have the lowest-risk cancer. But these guidelines have not been updated since 2021, and the Prostate Cancer UK argues they do not take into account advances in testing and diagnosis. Professor Vincent Gnanapragasam, professor of urology at the University of Cambridge, said: ' Active surveillance is the best treatment option for men whose cancer is unlikely to progress or cause them problems in their lifetime. 'But NICE's outdated guidelines have created a deeply concerning wild west on how surveillance is implemented by different health care teams. This inconsistency is resulting in a lack of confidence from patients in surveillance, who may instead opt to have treatment they may not have ever needed, risking harmful side effects.' According to the charity, overtreatment rates in England range from 2 to 24 per cent, and it warns that this results in a 'postcode lottery' in which some men receive treatment unnecessarily while others receive monitoring as they should. It also found 35 hospitals have created their own guidelines on what to do. Michael Lewis, 63, was diagnosed with prostate cancer in 2020. The nurse, from Dudley, said: 'My doctors told me my cancer was 'low-risk' and not likely to spread quickly, so I was put on active surveillance until 2024, when my PSA level started to rise again, so I had surgery to remove my prostate. 'Being on active surveillance meant I didn't have to have treatment until I needed to. I was able to continue my everyday life with no side effects. I'm glad I was able to get treatment when I needed it, but having the time without it was so valuable.' Amy Rylance, assistant director of health improvement at Prostate Cancer UK, said: 'Thanks to advances in research, we can now tell which prostate cancers require immediate treatment, and which men would be better off being monitored with blood tests and scans – enabling them to delay treatment or even avoid treatment altogether.' She said the treatments for prostate cancer, such as radiotherapy or surgery, can lead to 'life-changing side effects, like incontinence or erectile dysfunction, which can have a huge mental and physical impact on men'. 'NICE's outdated guidance is increasing the likelihood of men experiencing these life-changing side effects,' she added. 'It is causing confusion and inconsistency between hospitals in how active surveillance is implemented across England, leading to a postcode lottery of overtreatment.' The charity is now repeating its call for Nice to update its guidance on active surveillance, claiming this could help up to 5,000 men a year avoid overtreatment. The UK's National Screening Committee is currently assessing whether a national screening programme for prostate cancer should be rolled out. A NICE spokesperson said: 'We are committed to ensuring our guidelines continue to reflect the best available evidence and give patients the best possible outcomes. They are developed by an independent committee, including NHS clinical experts, and are kept under review to ensure they remain current. 'We are updating our prostate cancer guideline, including a review of the recommendations around active surveillance, and will be assessing whether our suspected cancer guideline recommendations around age-related thresholds for PSA tests for prostate cancer for onwards referral from primary care require updating.'
The Independent
11-08-2025
- Health
- The Independent
‘Outdated guidance' sees thousands at risk of prostate cancer ‘overtreatment'
Up to 5,000 men every year could avoid unnecessary treatment for prostate cancer if 'outdated' guidelines reflected latest evidence, a charity has said. Overtreatment of the disease can lead to side effects such as erectile dysfunction or incontinence, according to Prostate Cancer UK. Experts suggest closely monitoring certain patients can be the 'best' option for men whose cancer is unlikely to progress, although out-of-date guidance from the National Institute of Health and Care Excellence (Nice) on how this is implemented has created a 'wild west'. There are around 55,000 new cases of prostate cancer diagnosed in the UK every year. However, in some cases, the cancer is slow-growing and unlikely to ever cause the patient harm. These men benefit from being closely monitored with blood tests and scans, which is known as active surveillance. Nice guidance on active surveillance is designed to advise specialists on how to implement monitoring and which men should be monitored. However, it has not been updated since 2021, according to Prostate Cancer UK. Freedom of information (FOI) request analysis by the charity found around one in four (24%) of hospitals rely on Nice guidance alone to implement active surveillance. It also found 35 hospitals have created their own guidelines, which Prostate Cancer UK warned can lead to inconsistency and confusion among medics. The charity is now repeating its call for Nice to update its guidance on active surveillance, claiming it could help up to 5,000 men a year avoid overtreatment. It also claims the outdated guidance is hindering a screening programme for prostate cancer. Amy Rylance, assistant director of health improvement at Prostate Cancer UK, said: 'To reduce the harm caused by prostate cancer and build the foundations for a screening programme, we need to both save lives and prevent unnecessary treatment but official guidelines still haven't caught up with the clinical evidence. 'Concerns about overtreatment are a major reason the UK does not routinely screen for prostate cancer, despite it being the most common cancer in England. ' Acting on latest research that shows more men can safely opt for monitoring instead of treatment will reduce overtreatment and the harm it causes men. 'We asked Nice to update their active surveillance guidance two years ago, but our request was rejected. Now we have evidence this is potentially affecting thousands of men. Enough is enough.' The NHS uses a prostate-specific antigen (PSA) blood test to check for prostate conditions including prostate cancer or an enlarged prostate. Routine PSA testing is not currently offered on the NHS, but patients may be offered a PSA test if a GP suspects they have prostate cancer, while men over 50 can request a test from their GP even if they do not have symptoms. However, there have been calls to roll the test out across the health service, although some argue widespread use could identify cases which may not have caused problems or needed treatment. Vincent Gnanapragasam, a professor of urology at the University of Cambridge, said: 'Active surveillance is the best treatment option for men whose cancer is unlikely to progress or cause them problems in their lifetime. 'But Nice's outdated guidelines have created a deeply concerning wild west on how surveillance is implemented by different healthcare teams. 'This inconsistency is resulting in a lack of confidence from patients in surveillance, who may instead opt to have treatment they may not have ever needed, risking harmful side effects. 'Programmes for active surveillance that are standardised and individualised to a man's risk factors have been tested and proven to work.' The UK's National Screening Committee is currently assessing whether a national screening programme for prostate cancer should be rolled out. A Nice spokesperson said: 'We are committed to ensuring our guidelines continue to reflect the best available evidence and give patients the best possible outcomes. 'They are developed by an independent committee, including NHS clinical experts, and are kept under review to ensure they remain current. 'We are updating our prostate cancer guideline, including a review of the recommendations around active surveillance, and will be assessing whether our suspected cancer guideline recommendations around age-related thresholds for PSA tests for prostate cancer for onwards referral from primary care require updating.'
Daily Mail
11-08-2025
- Health
- Daily Mail
Thousands more prostate cancer patients could avoid overtreatment if NICE updated guidelines, charity says
Up to 5,000 men a year could avoid potentially harmful treatment for prostate cancer if 'outdated' guidelines reflected the latest evidence, a charity has said. Closely monitoring the disease with regular blood tests and scans can be the best option for those whose cancer is slow-growing and unlikely to endanger their life. But out-of-date guidance from the National Institute of Health and Care Excellence (Nice) on how this is implemented has created a 'wild west' , with some hospitals adopting their own approach. This has also led to a 'postcode lottery' of care, with patients in some parts of the country more likely to have unnecessary surgery, with the risk of side-effects such as erectile dysfunction or incontinence. Potential overtreatment for prostate cancer ranges from 2% to 24%, depending on where men are in the country, according to Prostate Cancer UK. One in four men diagnosed with prostate cancer each year have such slow growing disease that it is unlikely the cancer will ever cause them harm. Modern advances in how we diagnose prostate cancer mean clinicians can now tell which men need immediate treatment to stop their cancer progressing, and which men would be better off being monitored, enabling them to delay or even avoid treatment altogether. Nice guidance on active surveillance is designed to advise specialists on how to implement monitoring and which men should be monitored. However, it has not been updated since 2021, according to Prostate Cancer UK. Analysis of freedom of information responses by the charity found one in four (24 per cent) hospitals rely on Nice guidance alone to implement active surveillance. But 35 have created their own guidelines, which Prostate Cancer UK warned can lead to inconsistency and confusion among medics. The charity is now repeating its call for Nice to update its guidance, warning the outdated version is hindering a screening programme for prostate cancer. Amy Rylance, assistant director of health improvement at Prostate Cancer UK, said: 'To reduce the harm caused by prostate cancer and build the foundations for a screening programme, we need to both save lives and prevent unnecessary treatment but official guidelines still haven't caught up with the clinical evidence. 'Concerns about overtreatment are a major reason the UK does not routinely screen for prostate cancer, despite it being the most common cancer in England. 'Acting on latest research that shows more men can safely opt for monitoring instead of treatment will reduce overtreatment and the harm it causes men. 'We asked Nice to update their active surveillance guidance two years ago, but our request was rejected. 'Now we have evidence this is potentially affecting thousands of men. Enough is enough.' The NHS uses a prostate-specific antigen (PSA) blood test to check for prostate conditions including prostate cancer or an enlarged prostate. Routine PSA testing is not currently offered on the NHS, but patients may be offered a PSA test if a GP suspects they have prostate cancer, while men over 50 can request a test from their GP even if they do not have symptoms. Vincent Gnanapragasam, a professor of urology at the University of Cambridge, said: 'Active surveillance is the best treatment option for men whose cancer is unlikely to progress or cause them problems in their lifetime. 'But Nice's outdated guidelines have created a deeply concerning wild west on how surveillance is implemented by different healthcare teams. 'This inconsistency is resulting in a lack of confidence from patients in surveillance, who may instead opt to have treatment they may not have ever needed, risking harmful side effects. 'Programmes for active surveillance that are standardised and individualised to a man's risk factors have been tested and proven to work.' The Daily Mail is campaigning for a national prostate cancer screening programme, initially targeted at high risk men. 1 in 8 men will get prostate cancer. It's now the most diagnosed cancer in England. It's more important than ever to make prostate cancer treatment and care a priority. When people think of cancer, most will likely assume it needs treatment. But no two prostate cancers are the same, and for some men, their cancer is unlikely to spread or harm them, and can stay this way for many years. For these men, treatment might not be the best option. Instead, these men can be monitored with regular tests. This is called active surveillance. Avoiding treatment means avoiding potential side effects, such as urinary incontinence and erectile dysfunction. However, right now in England, outdated guidelines from the National Institute for Health and Care Excellence (NICE) mean fewer men are avoiding treatment than could be. NICE's guidelines for active surveillance have not been updated since 2021. In that time, huge improvements have been made in diagnosis which make active surveillance safer, and new research means doctors can tell more easily which cancers are more likely to spread. But the guidelines remain unchanged and have fallen behind clinical practice. They also contradict NHS guidelines. To understand the scale of the problem, Prostate Cancer UK submitted a freedom of information (FOI) request to UK hospitals. The results are stark: just a quarter (24%) of hospitals use NICE guidelines exclusively for active surveillance. The FOI identified that 35 hospitals had created their own guidelines for active surveillance. Clearly, NICE's outdated guidelines are contributing to national inconsistency and confusion. This has created a postcode lottery across the country, with some men more likely to be overtreated depending on where they live. Prostate cancer remains the only common cancer without a screening programme. The National Screening Committee will reach a decision this year, following evidence submitted by Prostate Cancer UK. Whatever the decision, the ultimate goal must be a national screening programme for all men at risk. That will not be possible without getting active surveillance right. Two years ago, Prostate Cancer UK asked NICE to update its active surveillance guidelines. NICE said they would not update them. This FOI gives us even more evidence the guidelines must be changed. I'm joining Prostate Cancer UK's urgent call to NICE. I urge my colleagues to do the same, so men can rest assured that they have the best information about whether treatment for prostate cancer is the best option for them. This includes those who are black or have a family history of the disease. The UK's National Screening Committee is currently assessing whether a national screening programme for prostate cancer should be rolled out. A Nice spokesperson said: 'We are committed to ensuring our guidelines continue to reflect the best available evidence and give patients the best possible outcomes. 'They are developed by an independent committee, including NHS clinical experts, and are kept under review to ensure they remain current. 'We are updating our prostate cancer guideline, including a review of the recommendations around active surveillance, and will be assessing whether our suspected cancer guideline recommendations around age-related thresholds for PSA tests for prostate cancer for onwards referral from primary care require updating.'
