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Prostate cancer: diagnosis and management [CG175]

Measuring the use of this guidance

Recommendation: 1.1.2

Offer men with prostate cancer individualised information tailored to their own needs. This information should be given by a healthcare professional (for example, a consultant or specialist nurse) and may be supported by written and visual media (for example, slide sets or DVDs).

What was measured: Percentage of trusts in England that provide prostate cancer services that have clinical nurse specialists in Urology available
Data collection end: March 2014
97%
Area covered: England
Source: Royal College of Surgeons National prostate cancer audit

What was measured: Percentage of trusts in England that provide prostate cancer services that have clinical nurse specialists in oncology available
Data collection end: March 2014
46%
Area covered: England
Source: Royal College of Surgeons National prostate cancer audit

What was measured: Proportion of prostate cancer patients who reported that, when they were told they had cancer, they were given written information about the type of cancer they had and it was easy to understand.
Data collection end: June 2015
79.9%
Data collection end: June 2016
81.3%
Data collection end: March 2018
82%
Area covered: England
Source: Quality Health. National Cancer Patient Experience Survey.

What was measured: Proportion of men who received radical prostatectomy that were given the name of a clinical nurse specialist.
Data collection end: April 2016
83%
Area covered: England
Source: Royal College of Surgeons National prostate cancer audit

What was measured: Proportion of men who received external beam radiation therapy that were given the name of a clinical nurse specialist.
Data collection end: April 2016
85%
Area covered: England
Source: Royal College of Surgeons National prostate cancer audit

What was measured: Proportion of prostate cancer patients who reported that the possible side effects of treatment(s) were explained to them in a way they could understand.
Data collection end: March 2018
72.7%
Area covered: England
Source: Quality Health. National Cancer Patient Experience Survey.


Recommendation: 1.1.3

Offer men with prostate cancer advice on how to access information and support from websites, local and national cancer information services, and from cancer support groups. [2008]

What was measured: Proportion of prostate cancer patients who reported that hospital staff gave them information about support or self-help groups for people with cancer.
Data collection end: June 2015
85%
Data collection end: June 2016
86.4%
Data collection end: March 2018
88.9%
Area covered: England
Source: Quality Health. National Cancer Patient Experience Survey.


Recommendation: 1.1.5

Ascertain the extent to which the man wishes to be involved in decision-making and ensure that he has sufficient information to do so. [2008]

What was measured: Proportion of prostate cancer patients who said that they were definitely involved as much as they wanted to be in decisions about their care and treatment.
Data collection end: June 2015
78.9%
Data collection end: June 2016
79.4%
Data collection end: March 2018
81.3%
Area covered: England
Source: Quality Health. National Cancer Patient Experience Survey.


Recommendation: 1.1.10

Tell men: - about treatment options and their risks and benefits in an objective, unbiased manner and - that there is limited evidence for some treatment options.

What was measured: Proportion of prostate cancer patients who reported that, before their cancer treatment started, their treatment options were explained to them.
Data collection end: June 2015
80.4%
Data collection end: June 2016
80.8%
Data collection end: March 2018
82.8%
Area covered: England
Source: Quality Health. National Cancer Patient Experience Survey.


Recommendation: 1.1.12

Adequately inform men with prostate cancer and their partners or carers about the effects of prostate cancer and the treatment options on their sexual function, physical appearance, continence and other aspects of masculinity. Support men and their partners or carers in making treatment decisions, taking into account the effects on quality of life as well as survival.

What was measured: Proportion of prostate cancer patients who reported that the possible side effects of treatment(s) were explained to them in a way they could understand.
Data collection end: June 2015
70.5%
Data collection end: June 2016
71.6%
Area covered: England
Source: Quality Health. National Cancer Patient Experience Survey.

What was measured: Proportion of prostate cancer patients who said that hospital staff discussed with them or gave them information about the impact cancer could have on their day to day activities.
Data collection end: June 2015
81.4%
Data collection end: June 2016
83%
Data collection end: March 2018
85.1%
Area covered: England
Source: Quality Health. National Cancer Patient Experience Survey.


Recommendation: 1.2.4

Carry out prostate biopsy following the procedure recommended by the Prostate Cancer Risk Management Programme in Undertaking a transrectal ultrasound guided biopsy of the prostate. [2008]

What was measured: Proportion of men with prostate cancer who had a biopsy who received a transrectal ultrasound biopsy before treatment.
Data collection end: May 2015
85%
Area covered: England
Source: Royal College of Surgeons National prostate cancer audit

What was measured: Proportion of men with prostate cancer who had a biopsy who received a transrectal ultrasound biopsy before treatment.
Data collection end: April 2016
84%
Data collection end: December 2016
88%
Data collection end: March 2017
88%
Number that met the criteria: 15588 / 21950
Data collection end: March 2017
88%
Number that met the criteria: 15588 / 21950
Area covered: England
Source: Royal College of Surgeons National prostate cancer audit


Recommendation: 1.2.6

Consider multiparametric MRI (using T2- and diffusion-weighted imaging) for men with a negative transrectal ultrasound 10–12 core biopsy to determine whether another biopsy is needed. [new 2014]

What was measured: Proportion of men with prostate cancer who received a multiparametric MRI in their diagnostic pathway.
Data collection end: May 2015
21%
Data collection end: April 2016
44%
Data collection end: December 2016
51%
Data collection end: March 2017
58%
Area covered: England
Source: Royal College of Surgeons National prostate cancer audit


Recommendation: 1.3.14

Offer radical prostatectomy or radical radiotherapy to men with high-risk localised prostate cancer when there is a realistic prospect of long-term disease control. [2008]

What was measured: Proportion of men with locally advanced prostate cancer who received external beam radiation therapy.
Data collection end: April 2016
42%
Area covered: England
Source: Royal College of Surgeons National prostate cancer audit

What was measured: Proportion of men with locally advanced prostate cancer who underwent radical prostatectomy.
Data collection end: April 2016
18%
Area covered: England
Source: Royal College of Surgeons National prostate cancer audit

What was measured: Proportion of men with locally advanced prostate cancer who received external beam radiation therapy.
Data collection end: December 2016
49%
Area covered: England
Source: Royal College of Surgeons National prostate cancer audit

What was measured: Proportion of men with locally advanced prostate cancer who underwent radical prostatectomy.
Data collection end: December 2016
22%
Area covered: England
Source: Royal College of Surgeons National prostate cancer audit

What was measured: Proportion of men with locally advanced prostate cancer who underwent radical prostatectomy within 12 months of diagnosis.
Data collection end: March 2017
20%
Area covered: England
Source: Royal College of Surgeons National prostate cancer audit


Recommendation: 1.3.15

Commissioners of urology services should consider providing robotic surgery to treat localised prostate cancer. [new 2014]

What was measured: Proportion of men who received radical prostatectomy who had the procedure carried out by a robotic approach.
Data collection end: April 2016
70%
Number that met the criteria: 1888 / 2699
Data collection end: December 2016
74%
Data collection end: March 2017
81%
Area covered: England
Source: Royal College of Surgeons National prostate cancer audit


Recommendation: 1.3.16

Commissioners should ensure that robotic systems for the surgical treatment of localised prostate cancer are cost effective by basing them in centres that are expected to perform at least 150 robot-assisted laparoscopic radical prostatectomies per year

What was measured: Percentage of trusts in England that provide prostate cancer services that carry out radical prostatectomy for prostate cancer who use robot-assisted laparoscopic prostatectomy
Data collection end: March 2014
43%
Number that met the criteria: 26 / 61
Area covered: England
Source: Royal College of Surgeons National prostate cancer audit

What was measured: Proportion of specialist multidisciplinary team (MDT) hubs that have robotic-assisted laparoscopic prostatectomy available.
Data collection end: March 2014
67%
Area covered: England
Source: Aggarwal A, Nossiter J, Cathcart P, van der Meulen , J , Rashbass J, Clarke N, and Payne H. (2016). Organisation of Prostate Cancer Services in the English National Health Service. Clinical Oncology, 28(8), pp.482-489.


Recommendation: 1.3.22

Consider high-dose rate brachytherapy in combination with external beam radiotherapy for men with intermediate- and high-risk localised prostate cancer. [new 2014]

What was measured: Proportion of specialist multidisciplinary team (MDT) hubs that have high dose rate brachytherapy available.
Data collection end: March 2014
44%
Area covered: England
Source: Aggarwal A, Nossiter J, Cathcart P, van der Meulen , J , Rashbass J, Clarke N, and Payne H. (2016). Organisation of Prostate Cancer Services in the English National Health Service. Clinical Oncology, 28(8), pp.482-489.


Recommendation: 1.3.26

Clinical oncologists should consider pelvic radiotherapy in men with locally advanced prostate cancer who have a higher than 15% risk of pelvic lymph node involvement and who are to receive neoadjuvant hormonal therapy and radical radiotherapy.

What was measured: Proportion of men identified as having a >15% risk of pelvic lymph node involvement who received pelvic radiotherapy.
Data collection end: April 2016
17%
Area covered: England
Source: Royal College of Surgeons National prostate cancer audit


Recommendation: 1.3.31

Ensure that men have early and ongoing access to specialist erectile dysfunction services

What was measured: Percentage of trusts in England that provide prostate cancer services that have sexual function services available
Data collection end: March 2014
90%
Number that met the criteria: 129 / 143
Area covered: England
Source: Royal College of Surgeons National prostate cancer audit


Recommendation: 1.3.34

Ensure that men with troublesome urinary symptoms after treatment have access to specialist continence services for assessment, diagnosis and conservative treatment. This may include coping strategies, along with pelvic floor muscle re-education, bladder retraining and pharmacotherapy

What was measured: Percentage of trusts in England that provide prostate cancer services that have specialist continence services available
Data collection end: March 2014
90%
Number that met the criteria: 129 / 143
Area covered: England
Source: Royal College of Surgeons National prostate cancer audit



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