Three hospitals in the UK are trialing a ‘one-stop’ prostate cancer diagnosis service, which is expected to reduce the time taken for a diagnosis from approximately 6 weeks to just days.
“This is an encouraging breakthrough in prostate cancer diagnosis that is genuinely world-leading. Whilst still early days the potential benefit to men is significant,” Simon Stevens, chief executive of NHS England, commented.
The process involves a novel scanning and diagnosis method that enables men to have an MRI scan and obtain their results on the same day. For those with a suspicious MRI, a biopsy is also done on the same day, using new FUSION technology, rather than multiple outpatient visits over 4–6 weeks.
Traditional ways of diagnosing prostate cancer involve an MRI scan followed by a biopsy, which involves the collection of up to around a dozen samples with a needle through the rectum, in order to locate suspect growths.
This novel technique uses highly detailed ‘multi-parametric’ MRI – mpMRI – scans offering higher quality images. Up to approximately 40% of patients who have an mpMRI scan will find out that they can safely avoid having a biopsy.
For those patients that do require a biopsy, the new FUSION machines overlay ultrasound images with 3D MRI scans to create a highly detailed map of the prostate that accurately show suspect areas for taking tissue samples, rather than choosing random locations.
Importantly, this allows clinicians to insert the needle through the perineum, as opposed to the rectum, which cuts the risk of infection by between 2–6% to approximately one case in 500.
Early results demonstrate that men are diagnosed in an average of 17 days after referral from GP – against a national average of 56 days.
Charing Cross Hospital, Epsom Hospital and Queen Mary Hospital’s Hospital in Roehamptom are piloting the novel approach, termed RAPID. Thus far, 400 men have been treated as part of the programme, it is hoped that over the next 2 years approximately 5000 men will be tested in the £1.6 million trial.
Heather Blake of Prostate Cancer UK commented: “The benefits of having a multiparametric MRI scan before a biopsy represent the biggest leap forward in prostate cancer diagnosis for decades.”
“Our target waiting times have considerably reduced,” explained Hashim Ahmed (Imperial College London). “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.”
“The NHS is now leading the way in ensuring all men get to benefit from this innovation,” Ahmed 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.”