NICE issues scope document for guideline on prostate cancer9/9/2005The National Institute for Health and Clinical Excellence (NICE) has commissioned the the National Collaborating Centre for Cancer to develop a clinical guideline on the diagnosis and treatment of prostate cancer for use, for use in the National Health Service (NHS) in England and Wales. This follows referral of the topic by the Department of Health (DoH). The guideline will provide recommendations for good practice that are based on the best available evidence of clinical and cost effectiveness.
Prostate cancer is one of the commonest cancers in men. Each year there are about 28,000 new cases in England and Wales and 9000 deaths. It is predominantly a disease of older men but around 20% of cases occur in men under the age of 65. Over the past 10 to 15 years there have been a number of significant advances in its management but also a number of major controversies, especially about the management of patients with early, nonmetastatic disease. There is evidence of practice variation around the country and of patchy availability of certain treatments and procedures. A clinical guideline will help to address these issues and offer guidance on best practice.
The guideline will cover adults with a histologically proven or agreed clinical diagnosis of primary adenocarcinoma of the prostate. No patient subgroups needing special consideration have been identified.
It will not cover asymptomatic adults with a raised prostate-specific antigen (PSA) level
and no histopathological diagnosis of prostate cancer, patients with metastatic disease involving the prostate or children and adults with rare epithelial and non-epithelial malignant tumours of the prostate, such as small cell carcinoma and rhabdomyosarcoma.
The guideline will address primary care (excluding population-based and opportunistic screening) as well as secondary care and tertiary care by specialist urological cancer teams. However. guidance on prostatic biopsy is being developed by the NHS Screening Programmes and will not be covered by this guideline.
It wil also cover:
- diagnostic investigations for clinical staging
- surgical management including radical prostatectomy, perineal radiofrequency ablation and cryotherapy dose rate) and unsealed radioactive sources (strontium-89 and samarium-153)
- hormonal treatments (neo-adjuvant, adjuvant and palliative; surgicaland pharmacologica)
- cytotoxic chemotherapy: neo-adjuvant, adjuvant and palliative.
- bisphosphonates
- novel biological and immunological agents.
- the management of common treatment-related side effects and complications.
The consultation period for the scope document is from 20 June to 19 July 2005. The development of the guideline recommendations will begin in November 2005. The Patient and Public Involvement Programme and the NCCC are looking for nominations for patients and/or carers to sit on the group developing the guideline.
