Prostate Cancer: NICE Clarification Boosts NHS Treatment Options

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Cancer / Oncology
Article Date: 28 Jun 2008 - 1:00 PDT

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Physician experts at the British Association of Urological Surgeons' (BAUS) annual meeting this week heard how discussions with NICE have opened the way for patients with prostate cancer to have continued access to cryotherapy - a promising therapy threatened by earlier NICE guidance published in February.

At a session discussing the NICE Clinical Guideline on Prostate Cancer, urologists reiterated their concern that its recommendations will harm survival rates. In the UK, prostate cancer survival rates are below the European average.

The NICE Guideline advocates greater reliance on active surveillance and recommended that newer treatments such as cryotherapy and high intensity focused ultrasound (HIFU) should only be used in the context of clinical trials. Given the ethical difficulty of establishing such trials, clinicians and patients feared that PCTs would withdraw funding.

In contrast, last year the prestigious European Association of Urology (EAU) recognised the important role of cryotherapy in treating prostate cancer by including it in its prostate cancer guidelines. More recently, the American Urological Association (AUA) announced best practice statements citing cryotherapy as a treatment option for both primary and recurrent localized prostate cancer.

Prof. Damian Greene, Consultant Urologist at Sunderland Royal Hospital in the UK, considers cryotherapy a valuable option in the treatment of primary and recurrent prostate cancer. Prof. Greene commented: "Cryotherapy is a significant alternative to traditional treatments for prostate cancer, such as radical prostatectomy and external beam radiation treatment. Patient satisfaction with cryoablation is high due to its minimally invasive approach which allows returning to active life quicker than with alternative treatments."

Since publication of the Guideline, NICE has been in discussion with industry, BAUS and the Health Technology Assessment programme of the National Institute for Health Research to identify a way forward. Discussions are progressing with BAUS to establish national data collection. In the meantime, NICE has clarified that surgeons collecting local data available for national analysis will satisfy the recommendation on use of cryotherapy, enabling PCTs to continue funding.

Professor Greene comments: "This is excellent news, as prostate cancer is a challenging condition. Clinicians need cryotherapy as a treatment option and it's great that patients can now continue to benefit from it within the NHS."

Independent endorsement by the EAU and AUA recognises the major technological advances in cryoablation and the growing evidence base. Leading the way in the field, is Galil Medical's Presice(TM) Cryoablation System, featuring Multi-point Thermal Sensor volumetric temperature readings for monitoring of cryoablation procedures, patented 17g needle design with sharper tips, and IceVue(TM) planning and simulation software.

The Presice Cryoablation system has been designed to achieve optimal benefit with minimal intervention and is licensed for the cryotherapy treatment of prostate and renal cancer. For further information, please go to www.galilmedical.com.

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