07 Mar 2018
The NHS is using cutting edge technology to help slash diagnosis times for prostate cancer from six weeks to one day in a world-leading new approach that virtually eliminates the risk of deadly sepsis.
The NHS is determined to cut the mortality rate for prostate cancer in the same way that has seen breast cancer rates decline by 10%.
The usual process is an MRI scan followed by a biopsy where around a dozen samples may have to be taken with a needle through the rectum, in order to locate suspect growths on the prostate.
Under the new ‘rapid pathway’ approach, which is being developed in three hospitals across West London, men have a scan, get their results and can have any necessary biopsy, using new FUSION technology, in one day, rather than multiple outpatient visits over four to six weeks.
The approach involves specialist clinical expertise as well as equipment and NHS England is currently looking into how it could be rolled out to other major cancer centres across England.
The new technique uses highly detailed ‘multi-parametric’ MRI – mpMRI – scans, currently being rolled out across the NHS, which provide much higher quality imagery. Between a third and 40% of patients who have an mpMRI scan will find out on the same day that they do not have prostate cancer and can safely avoid having a biopsy. The machines are also able to pick up growths that are much harder to detect.
If a biopsy is needed, the new FUSION machines will overlay ultrasound images with 3D MRI scans to create a highly detailed map of the prostate that can be used to accurately target suspect areas for taking tissue samples. The new system means an area as small as a grain of rice can be hit first time.
This precision allows clinicians to insert the needle through the perineum, rather than the rectum, reducing the risk of infection from between 2% to 6% to around one case in 500.
This new approach is being piloted at Charing Cross Hospital, Epsom Hospital and Queen Mary’s Hospital in Roehampton by RM Partners, the Cancer Alliance for west London.
Simon Stevens, 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.”
Professor Hashim Ahmed, new chair of NHS England’s Clinical Expert Group for Prostate Cancer and Chair of Urology at Imperial College London, has been leading the new approach. He said: “The NHS has led the research that underpins this RAPID pathway to improve the diagnosis of prostate cancer. The NHS is now leading the way in ensuring all men get to benefit from this innovation. 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.”