Re: A disservice to those with prostate cancer - Telegraph

[Guest guest]

Kathy

Thanks

This continues to worry me and the attitude of some NHS trusts too.

Our Sunday paper headlined the story of a lady who wanted to pay for a drug and the trust said that she would no longer be an National Health Service patient. This is not the norm.

It may be money that is driving that issue. I think money is also the root of the screening issue. We haven 't enough urologists to cope.

B

A disservice to those with prostate cancer - Telegraph

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/12/16/ncancer216.xml Orhttp://tinyurl.com/2rxc9r Last Updated: 3:27am GMT 16/12/2007CommentaryAs 2007 draws to a close it is sad to contemplate that during the yearanother 10,000 men in the UK will have lost their lives to prostate cancer,and that 10,000 families this Christmas will be grieving the loss of a lovedone as a result.Although the annual death toll from prostate cancer is the equivalent to thecrashing of a fully laden jumbo jet every fortnight, little is heard aboutthis silent killer, and it is hard to see how the forthcoming guidance fromthe National Institute for Health and Clinical Excellence (Nice) will domuch, or indeed anything, to reverse the situation.Compared with breast and lung cancer the cancerous cells of the prostate arerelatively slow growing, often doubling in number only every two years orso.This slow growth rate provides a window of opportunity for cure, sinceprostate cancer can be reliably eradicated while it remains within thegland, but becomes incurable once it spreads to the lymph nodes or bones.Indeed, every one of those men who have died of the disease this year couldpotentially have been cured, if only their disease had been recognisedearlier.Yet Nice pays scant attention to early detection of the disease, and theGovernment has just ruled out the introduction of a mass screeningprogramme.Current draft guidance from Nice suggests that as a one-off measurement,blood tests marker for prostate disease are not accurate enough.In fact, if screening happens regularly enough, checks on the rise ofProstate Specific Antigen, rather than its absolute value, enable us todetect the cancer risk increasing.Meanwhile, the body dismisses new methods of treatment that are so oftenemployed abroad, preferring instead to endorse "watchful waiting" as thedisease develops and eventually spreads.Doctors working in the field want to eradicate the cancer while causingminimal "collatoral damage" to sexual and urinary functions.We know from experience how central these are to a man's quality of life.New technologies in robotics now permit the removal of a cancerous prostatethrough a tiny keyhole near the belly button with minimal blood loss,preserving the tiny nerves which protect erectile function.High intensity focussed ultrasound (HIFU) permits a minimally invasive meansof destroying cancer, while cryosurgery kills cancer cells by freezing them.Nice has the luxury of time to hedge its bets and await the results of longterm medical trials, which could take decades to provide results.The problem for those of us sitting opposite a patient and his family inclinic is what to do here and now.Nobody wants to die from prostate cancer - often a slow and painful demise -but of course no one wants unnecessary treatment, especially if impotenceand incontinence are the result.New treatment options take us nearer to the "Holy Grail" of effectivetreatment with minimal side-effects. What is needed is a health servicewhich harnesses today's scientific breakthroughs and focusses on the future.Unless it does so, the death toll among Britain's men will continue to rise.• Prof Kirby is chair of the charity Prostate UK.