05 February 2020, Ian Le Guillou -
A new online tool developed with funding from The Urology Foundation could help men with localised prostate cancer to choose the right treatment for them.
It is hoped that this tool will empower prostate cancer patients to make the decisions that are right for them and give clinicians confidence that they are counselling patients appropriately.
You can use the Predict Prostate tool here: https://prostate.predict.nhs.uk/
When deciding between treatment options, men and their doctors need to consider if the cancer could be life-threatening. That will depend on the aggressiveness of the cancer and the expected lifespan of the man.
In some cases, the decision will be clear cut. A very aggressive cancer in a younger man will require treatment, such as surgery or radiotherapy, to prevent it from spreading to other parts of the body and becoming incurable. Meanwhile, if the cancer is clearly non-aggressive, then doctors may recommend active surveillance, a process where regular scans and tests monitor the cancer for any signs of growth.
However, for a large number of men, their cancer falls somewhere in between and the choice is not clear. For older men, even aggressive cancers may not cause any harm within their lifetime. The side-effects from treatment can be life-changing, so it is important that men do not go through this unnecessarily.
To help men and their doctors decide what to do, TUF funded Mr David Thurtle from the University of Cambridge to develop a tool that predicts the likelihood of a case of prostate cancer being deadly.
Predict Prostate used the information from over 12,000 health records to predict the risk of dying both from prostate cancer and other causes, as well as possible side effects from treatment. David has since validated the tool by comparing its predictions against the health records of over 69,000 men from Sweden. This means that we can have a lot of confidence in the results that it provides. The NHS has adopted the tool and NICE has endorsed it, thanks to the evidence showing that it could improve treatment decisions.
David and his colleagues found that doctors tend to estimate that diagnosed men were twice as likely to die from their prostate cancer, compared to the results from Predict Prostate. After seeing the figures from the tool, doctors were less likely to recommend surgery or radiotherapy for most cases, particularly for older patients.
Figures published in January showed that prostate cancer is now the most commonly diagnosed cancer in the UK, with over 49,000 men diagnosed in 2018. As more men than ever find themselves in need of guidance for their treatment options, Predict Prostate could help them to make the best choice.
“TUF funding provided the reassurance that others, including patients and urology professionals, felt the project was of value and worthwhile. The funding meant I could work full time on the project, which was crucial to delivering the tool in a timely fashion. TUF’s support was invaluable in enabling the ongoing patient study to be ‘portfolio-adopted’ and recognised by the clinical research network,” said David
“Above all this, TUF have been personally encouraging and supportive and have a real interest in supporting and nurturing urology trainees.”
The website is prostate.predict.nhs.uk and is aimed at patients who would like more information about their choices.
