For the recognition of the Movember month, we partnered with thought leaders across the NHS, civil society and life sciences to discuss prostate cancer and improvement to care pathways.
In the most recent episode of Innovating Healthcare, Chamber UK called attention to another national crisis – prostate cancer. The session was chaired by former Deputy National Medical Director at NHS England, Professor Mike Bewick. The discussion included three highly qualified panellists who brought their experience to enlighten us concerning the disease, its impact and potential solutions.
The panellists for the session included:
- Dr Jayne Spink – Translational Research Director, Prostate Cancer Research
- Professor Mark Emberton – Dean, Faculty of Medical Sciences, UCL
- Christopher King – Category Leader, Oncology, Rare Disease & Neurology, IQVIA
The discussion focused on advances in treatment and the screening of the disease. The panellists highlighted the role of real-world data and problems of lack of equity, awareness and early diagnosis. The infrastructure of clinical research and issues regarding diagnosis and treatment were also major discussion points.
Societal impact and awareness
Starting the discussion on a positive note, Professor Emberton mentioned the UK’s transformation in the global pathway for prostate cancer patients. The UK initiated innovation in metastatic diseases that have prolonged life for patients. However, there is still much to be improved regarding implementation and equity of access to treatments and diagnostics worldwide. Catching the disease in its early phase requires preclinical identification, PSA, imaging, biopsy, and various other interventions.
From her years in translational research, Dr Spink mentioned that the lack of public awareness regarding prostate cancer risk and symptoms has stopped men coming forward. She explained there are around 57,000 new diagnoses per year, an increase in hospital admissions, more than 400,000 people are or have been patients of prostate cancer, and almost 1 out of every six would be diagnosed in their lifetime. Covid also had an impact on men not coming forward for testing. Therefore, there is a lot to be gained from the awareness of acute diseases.
On the topic of getting the public involved in clinical research, King advocated collecting clinical data and its relevancy in generating new, innovative therapies. King stressed the importance of real-world data in increasing awareness and finding early symptoms of prostate cancer. Depending on the country, there are certain age bands, races, and ethnicities to keep a check on. Improvements have been seen in the identification of patients using AI, ML, and of course, real-world data for PSA testing.
Infrastructure issues and regional dichotomy
From his experience relating to Integrated Care Systems, Professor Emberton explained the difficulty in introducing new health technologies. He noted that new, less invasive therapies for prostate cancer had shown amazing responses. But these are “yet to be approved due to a lack of largely calculated evidence.”
Dr Spink added the tendency for London centricity, mentioning the need for ICSs to address diagnostic capacity and build a rapid diagnostic pathway across England.
Dr Spink also stressed the personal impact of prostate cancer on daily life. Patients need access to all information regarding the disease, including treatment choice, symptoms, side effects and how to control them, and support offered by national and local voluntary organisations. She emphasised the importance of real-world data. She said:
‘’There is a lot to be gained from improving how we might systematically communicate with and collect outcome and experience measures from people affected by prostate cancer.’’
Registering the patient will help collect and use patient data with their consent and keep in contact with them in case of treatment availability.
Talking about the progressions made in science, King shared:
‘’As we talk about innovation, there is an innovation on the side of data collection, and eConsenting is now one of those elements that have become much better understood and communicated with patients.‘’
Stressing the importance of the relevant expert teams, King added that countries across the globe have been struggling with strategy formulation for prostate cancer and, ultimately, with patient results. King continued:
‘’I think ensuring that you have created the right team, you have urologists, you have charities involved in the conversation, you have patients advocacy or patients that are specifically involved in those conversations, you can start to create clinical trials or more broadly, research that fits with the challenges of urologists themselves, the patients, as they are embarking on their diagnostics retreatment journey.‘’
Quality control, issues and investment
Talking about the issues regarding diagnostics, Professor Emberton mentioned the position of the UK in creating an MRI standard, leaving other countries still catching up. The quality of the image is what brings in the difference. Relating to his own experience, he stated the frustration of seeing international patients with suboptimal imaging, that are unable to get a diagnosis.
Professor Emberton highlighted the importance of quality control and assurance, suggesting it was an area that still required work.
Professor Emberton also hinted at the possibility of quick, affordable and portable scans requiring no injection or a doctor to be present.
Continuing the theme of making prostate cancer a priority for investment, Professor Emberton stated that to prove their investment worthwhile, showing proof of cost-effectiveness and reduced premature death is essential. He added that a grant is under process, and hopefully, it will be under work in two years.
Pressing on prioritising the issue, Dr Spink added that it is a public health issue, and early treatments have led to an improved quality of life. He pushed on the importance of infrastructure, funding models and skills regarding new treatments and diagnoses.
The panellists concluded that although the UK has demonstrated advances in the treatment of prostate cancer, there is much to be achieved regarding clinical infrastructure and reforms. The lack of awareness, equity and the delay in interventions has brought an increase in the number of patients. Better use of data, tools, eConsent, and getting quick grant approvals will set the nation ahead, and policymakers need to pay urgent attention to this matter.
Photo credit: Eva Rinaldi