Physician experts at the British Association of Urological Surgeons'
(BAUS) annual meeting this week heard how discussions with NICE have opened
the way for patients with prostate cancer to have continued access to
cryotherapy - a promising therapy threatened by earlier NICE guidance
published in February.
At a session discussing the NICE Clinical Guideline on Prostate Cancer,
urologists reiterated their concern that its recommendations will harm
survival rates. In the UK, prostate cancer survival rates are below the
European average.
The NICE Guideline advocates greater reliance on active surveillance and
recommended that newer treatments such as cryotherapy and high intensity
focused ultrasound (HIFU) should only be used in the context of clinical
trials. Given the ethical difficulty of establishing such trials, clinicians
and patients feared that PCTs would withdraw funding.
In contrast, last year the prestigious European Association of Urology
(EAU) recognised the important role of cryotherapy in treating prostate
cancer by including it in its prostate cancer guidelines. More recently, the
American Urological Association (AUA) announced best practice statements
citing cryotherapy as a treatment option for both primary and recurrent
localized prostate cancer.
Prof. Damian Greene, Consultant Urologist at Sunderland Royal Hospital in
the UK, considers cryotherapy a valuable option in the treatment of primary
and recurrent prostate cancer. Prof. Greene commented: "Cryotherapy is a
significant alternative to traditional treatments for prostate cancer, such
as radical prostatectomy and external beam radiation treatment. Patient
satisfaction with cryoablation is high due to its minimally invasive approach
which allows returning to active life quicker than with alternative
treatments."
Since publication of the Guideline, NICE has been in discussion with
industry, BAUS and the Health Technology Assessment programme of the National
Institute for Health Research to identify a way forward. Discussions are
progressing with BAUS to establish national data collection. In the meantime,
NICE has clarified that surgeons collecting local data available for national
analysis will satisfy the recommendation on use of cryotherapy, enabling PCTs
to continue funding.
Professor Greene comments: "This is excellent news, as prostate cancer is
a challenging condition. Clinicians need cryotherapy as a treatment option
and it's great that patients can now continue to benefit from it within the
NHS."
Independent endorsement by the EAU and AUA recognises the major
technological advances in cryoablation and the growing evidence base. Leading
the way in the field, is Galil Medical's Presice(TM) Cryoablation System,
featuring Multi-point Thermal Sensor volumetric temperature readings for
monitoring of cryoablation procedures, patented 17g needle design with
sharper tips, and IceVue(TM) planning and simulation software.
The Presice Cryoablation system has been designed to achieve optimal
benefit with minimal intervention and is licensed for the cryotherapy
treatment of prostate and renal cancer. For further information, please go to
galilmedical.