Prostate Cancer Patient Outcomes Shouldn’t Be A Postcode Lottery

Prostate cancer is the most common cancer in men across the United Kingdom, with approximately 1 in 8 men being diagnosed with prostate cancer at some point in their life. Affecting more than 50,000 men every year, it is important to raise awareness of the signs and symptoms to look out for.

The good news is that the number of men having treatment for prostate cancer has jumped by more than a quarter in England in one year, according to new NHS figures. Almost 4,000 men received prostate cancer treatment in August 2022 (3,898) compared to just over 3,000 in the same month in 2021.

Furthermore, more people than ever before are receiving urological checks – including for prostate cancer– with over 40,000 more between August 2021 and August 2022, compared to the year before (243,043 in the year ending August 2022 compared to 202,252 in the year before).

These statistics are positive – but the post-pandemic increase may not come as a surprise, as at least 14,000 fewer men were diagnosed during the COVID-19 pandemic, with referrals and treatments for prostate cancer dropping between 2019-2021 because men were less likely to visit their GP and hospital.

However, the bad news is that despite the increase in figures for men to get checked and treated, there remains a disparity between men being diagnosed – especially at an early stage – with prostate cancer, and the region they live in.

Prostate Cancer UK has recently warned that there is a huge variation in the likelihood of men being diagnosed when it’s too late for a cure. In London, 1 in 8 men with prostate cancer are diagnosed with metastatic disease – which is an advanced prostate cancer where the cancer has spread from the prostate to other parts of the body – rising to more than 1 in 3 in Scotland. Wales, Northern Ireland, and the North and Midlands of England are also shown to be badly affected.

Additionally, statistics around later diagnoses were also highlighted in the latest National Prostate Cancer Audit (NPCA), which reveals that men in more deprived areas are more likely to be diagnosed at a later stage, where it is more likely for the cancer to be less treatable.

Unlike the female equivalent – breast cancer – there is no automatic screening for prostate cancer.  Many men have to request the prostate cancer blood test, or PSA (Prostate Specific Antigen) test, themselves. And in some cases are even advised against this. Also, with many men not experiencing any symptoms, particularly in the early stages, or disregarding them as a sign of getting older, such as a weak bladder or erectile dysfunction, prostate cancer diagnoses can be overlooked – and more needs to be done to change this.

GPs have an incredible role to play in this by proactively engaging with higher-risk men, or men that meet the requirements, to have a PSA test. GPs are a patient’s first point of contact for any health issues they may be experiencing. Therefore, an essential component of that support is opening up the dialogue around prostate cancer, from the earliest possible stage.

By having a PSA test, even to monitor the results as a baseline, we can identify the men at potential risk earlier – resulting in more years lived with a high quality of life for patients and a reduction in prostate cancer mortality.

A later diagnosis also often means that men will have fewer viable, less invasive treatment options available to them. As it stands today, not all men have access to the latest biopsy techniques or treatment options (Low-Dose-Rate Brachytherapy, radiotherapy, radical prostatectomy, hormone treatment), as they too can often be postcode dependent – which in turn, limits men’s lifestyle choices.

It is vital that we tackle these inequalities, and enable men across the country to access the support and options they need, from diagnosis to treatment. Ultimately, patient choice is key – and that demands accurate and fair information and option availability – irrespective of location. Let’s stop relying on a man’s own initiative or a postcode lottery to make changes to the prostate cancer pathway for thousands of men across the United Kingdom.

– Saheed Rashid, Managing Director, BXTA