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NICE prostate guidelines updated based on Cambridge research

A Cambridge developed model to categorise the risk of prostate cancer has been added to the National Institute for Health and Care Excellence (NICE) guidelines and adopted as standard practice in the NHS.

Patients who are newly diagnosed with prostate cancer are currently filtered into three groups: low, intermediate or high-risk. A new risk model developed in Cambridge - the Cambridge Prognostic Groups (CPG), has shown re-categorising these groups into five categories, based on more detailed information is better able to predict disease aggressiveness and benefit patient care.

Developed by the University of Cambridge, Cambridge University Hospitals and supported by the NIHR Cambridge BRC, researchers have demonstrated that having clearer, detailed groups will help monitor and manage the disease.

NICE, which provides national guidance and advice for health, public health and social care practitioners, has recognised this new grouping system as an improved method when deciding on treatments for newly diagnosed patients and have now amended their guidelines for treating prostate cancer.

The prostate is a gland located underneath the bladder and surrounds the urethra (tube that carries urine). This gland can grow and could potentially turn cancerous. The causes of prostate cancer are largely unknown and signs of the disease include blood in urine or semen, difficulty urinating or bone pain.

Those referred with a raised blood level of Prostate Specific Antigen (PSA) or other worrying symptoms have tests to determine any presence of cancer. If they are diagnosed with the disease, they were normally categorised in one of three groups, depending on the severity of the cancer, and start treatment.

Vincent Gnanapragasam - head and shoulders
Professor Vincent Gnanapragasam

However, new research from Professor Vincent J Gnanapragasam, Professor of Urology and the team demonstrated that some patients did not fit neatly into any of the categories and so did not require the same monitoring and treatments compared to others in the respective groups.

After years of collecting more detailed health information and testing, the team found having five categories – Cambridge Prognostics Groups 1-5– was a better method to inform the best treatment choice and also likelihood of the disease responding to treatment.

From this extensive research, NICE have now recognised all newly diagnosed men in the UK should be risk-categorised by the new five category model developed in the CPG’s criteria. This will lead to better care and tailoring appropriate treatment to patients.

Professor Gnanapragasam said: “The current three-tier model has been used for over twenty years, we’ve come a long way since then and have a better understanding of prostate cancer. Having this new model will make sure we are able to better predict how men with similar risk types will respond to treatment. More importantly it will also reduce the amount of unnecessary treatments for those where the disease is unlikely to cause problems during a man’s natural lifespan.

Having our model independently reviewed and adopted by NICE and now recommended in mainstream treatment is a testament to the robustness of our research all the hard work we have done to improve how we manage prostate cancer.

Professor Vincent Gnanapragasam