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Sunday, December 04, 2022

New prostate cancer test procedure could ‘greatly reduce’ risk of infections

New techniques for prostate cancer biopsies that could stop thousands of men suffering complications have been given the green light from watchdogs.

The National Institute for Health and Care Excellence (NICE) has backed four new types of diagnostic device, saying they reduce the chances of biopsy-related sepsis.

They said the new techniques could “greatly reduce” the risk of infections, cutting the number of men readmitted to hospital and the use of antibiotics.

Every year, approximately 200,000 men undergo biopsies because prostate cancer is suspected.

Research suggests about three per cent will suffer some form of complication, with sepsis among the most common.

NICE said research suggested that the new “freehand needle positioning devices” were just as effective as traditional techniques at detecting cancer, with lower risks of infections.

One in six men will be diagnosed with prostate cancer during their lifetime, with more than 50,000 cases diagnosed annually.

Procedure should benefit ‘both the patient and NHS’

The new guidance looks at four devices which use local anesthetic transperineal (LATP) prostate biopsy.

Experts said the targeted nature of the investigation could help to reduce the risk of infections.

The devices involved are PrecisionPoint, EZU-PA3U device, Trinity Perine Grid, and UA1232 puncture attachment.

In a LATP biopsy, the needle enters the body through the perineum.

Until now, most men undergoing biopsies for prostate cancer have undergone transrectal ultrasound guided (TRUS) biopsy samples. These use a needle inserted through the rectal wall via the anus. However, TRUS can be associated with serious infections, sometimes requiring hospital admission and antibiotics, the guidance states.

Dr Mark Kroese, chairman of the NICE diagnostics advisory committee, said the new recommendation would give those with suspected prostate cancer a new option to consider.

He said: “The committee heard from patient experts that there are concerns they are not getting clear and accurate information about having a biopsy, they are worried about an associated risk of infection, and the severity and duration of side effects.

“LATP using a freehand needle positioning device for taking a prostate biopsy should reduce unnecessary infections and therefore antibiotic use, benefitting both the patient and the NHS.”

‘Quick and cost-effective’ way to detect prostate cancer

Chiara De Biase, director of support at Prostate Cancer UK, said LATP biopsies were “a quick and cost-effective way of detecting prostate cancer” which had been available for some men on the NHS for several years.

“Most importantly, however, they result in fewer cases of infection and sepsis than more traditional TRUS biopsies, and ultimately cause less harm to men,” she said.

“That’s why we’re pleased that this technique will now be more widely available to men where clinically appropriate.”

The NICE guidance also recommends that clinicians are encouraged to ask people with suspected prostate cancer to sign up to the ongoing TRANSLATE clinical trial, which will provide further comparative evidence on prostate biopsy tests.

It follows calls for a wider expansion of targeted treatments, which can destroy the most difficult to reach tumors, while causing fewer side effects than traditional forms of treatments.

Treatments offered normally involve surgery to remove the prostate or radiotherapy, both of which can cause distressing side-effects.

Last year, the NHS began a therapy called Nanoknife to treat prostate cancer patients by University College London Hospital.

Charities said up to 20,000 men a year diagnosed with localised disease could be helped by more targeted treatments, calling for more research so the use of such methods can be expanded.

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