(Title Image: University College London)
P-05-849: “All men in Wales should have access through the NHS to the best possible diagnostic tests for prostate cancer”
Submitted by Stuart Davies
Petition Supporting Evidence
- Prostate cancer can be difficult to diagnose and often requires painful biopsies and/or a rectal ultrasound probe. The test uses needles which could miss areas where a tumour is developing and biopsies can produce a “false positive”.
- Multi-parametric MRI (mpMRI) is a less invasive method which combines different scan images to create a picture of a man’s prostate after the injection of a dye.
- mpMRI is currently only available in three of Wales’ 7 health boards and only one health board is doing it to a standard which safely rules out the need for a biopsy. A private mpMRI can cost £900.
Chair of the Petitions Committee, UKIP’s David Rowlands, said prostate cancer was the most common male cancer with over 2,500 cases in Wales each year.
93% of aggressive cancers detected by mpMRI
Mark Isherwood AM (Con, North Wales) said Wrexham Maelor Hospital was one of the sites chosen to pilot mpMRI. The success rate was pretty high, with 27% of men avoiding needing a biopsy and 93% of aggressive prostate cancers detected.
NICE guidance already states that mpMRI should be used in cases where patients show signs of requiring a more detailed biopsy, and he said the Health Minister’s assertion that NICE guidelines were being followed was “patently not true”.
Rhun ap Iowerth AM (Plaid, Ynys Môn) said the scan showed clear promise by giving a clearer picture of the prostate and being less likely to produce false results. It begged the question:
“The reason the Welsh Government introduced the new treatments fund was precisely because the Welsh NHS couldn’t meet its legal obligations to ensure new treatments were made available within three months of NICE approval. So, that point has been conceded already, and we’re currently in a situation where NICE has approved the technology for use in diagnosis but it’s still not being done right across Wales, so ‘why?’ is the question. “
– Rhun ap Iorwerth AM
The petitioner found the lack of consistency between health boards as “unacceptable” and the petitioner has been inundated with stories of men who’ve had to have a private scan – sometimes borrowing money to pay for one.
Caroline Jones AM (Ind, South Wales West) spoke of her husband’s experiences. He’s had to undergo testing for prostate cancer, which included a painful biopsy. If he had lived 15 miles to the north-east, he would’ve had a mpMRI scan.
David Melding AM (Con, South Wales Central) called for more clarity on NICE guidelines when it comes to screening as it often caused public confusion. The whole policy of screening needs a review as technology changes and preventative medicine becomes more important and practical.
New prostate scan guidelines due in April
Health Minister, Vaughan Gething (Lab, Cardiff S. & Penarth) said the trials in Wales showed positive signs with clinicians wanting mpMRI rolled-out everywhere. There was a point behind the limited availability of new treatments though:
“But there is this point about, when we consider each potential advance in healthcare, what we do as a whole system, and in decision making, to consider the evidence for the best intervention and then to try to take a consistent national approach to delivering it once that evidence base is sound and accepted. So, NICE are committed to publishing their revised guidelines in April.”
– Health Minister, Vaughan Gething
If mpMRI is to be rolled out then it won’t be a simple matter; it’ll require careful planning on scanning capacity, staffing and staff training.