7 Implementation and audit
7.1 NHS organisations and clinicians who care for men with prostate cancer should review their current practice and policies to take account of the guidance set out in section 1.
7.2 Local guidelines, protocols or care pathways that refer to the care of men with prostate cancer should incorporate the guidance.
7.3 To measure compliance locally with the guidance, the following criteria could be used. Further details on suggestions for audit are presented in appendix C.
7.3.1 A man with hormone-refractory metastatic prostate cancer is offered docetaxel, within its licensed indications, as a treatment option only if his Karnofsky performance-status score is 60% or more.
7.3.2 For a man with hormone-refractory metastatic prostate cancer who is treated with docetaxel, treatment with docetaxel is stopped when any of the following circumstances occur:
planned treatment of up to 10 cycles is completed, or
the man experiences a severe adverse event, or
there is evidence of progression of disease.
7.3.3 Repeat cycles of treatment with docetaxel are not provided if the disease recurs after completion of the planned course of chemotherapy.