Prostate cancer pilot speeds up diagnosis at North Manchester General

The Urology department at North Manchester General Hospital is piloting a new Rapid Diagnostic Prostate Pathway that is improving patient care and ensuring patients are treated faster than ever before.

The new pathway is for patients referred from their GP with suspected prostate cancer. Previously, patients would come and see a Urology consultant, have a scan (mpMRI) and then a biopsy, which could take up to four weeks.

Under the pilot, suitable patients have an MRI scan prior to seeing the consultant, which is then available in time for the clinic appointment.

This means the consultant can make a decision as to whether the patient requires a prostate biopsy, surveillance or can be discharged at the first appointment. If a biopsy is required, this is done on the same day.

Prostate cancer is the second most common diagnosed cancer in England, and the most common cancer diagnosed in men.

North Manchester General Hospital is run by the Northern Care Alliance NHS Group which brings together the Salford Royal and Pennine Acute hospital trusts.

From April 2020, NHS England is implementing a new diagnostic standard, with emphasis on the importance of receiving a diagnosis or ruling out of cancer for patients within 28 days of referral from a GP.

The new Rapid Diagnostic Prostate Pathway means patients who are diagnosed with cancer can be offered treatment earlier, and those who are not diagnosed with cancer, can be given an ‘all clear’ sooner, reducing the anxiety felt at a very stressful time.

Mr Jacob Cherian, urology consultant and cancer lead at North Manchester Care Organisation said: “This new pathway is ground breaking and is helping us diagnose or rule out significant prostate cancer in the majority of patients, much earlier than ever before. This is helping the doctors avoid unnecessary biopsies for some patients and to select the most appropriate type of biopsy for patients who require one.”

This pilot started on 29 April and the NCA has invested in new Template Biopsy equipment, which is used for a specific type of prostate biopsy.

Previously, patients would have to travel to the Christie hospital, which could result in a delay in their treatment, however, this pilot allows patients to be treated locally and sooner than before.

Why mpMRI before the clinic appointment and biopsy?

1. Improves the detection accuracy of clinically significant cancer

2. Potential to dramatically improve patient experience with a potential ‘rule-out’ of prostate cancer without the need for an invasive procedure

3. Patients with non-suspicious mpMRI avoid the need for biopsy and its associated risks such as infection

Patient benefits:

• Empowerment from information about the diagnostic process provided at point of referral.
• Reduced anxiety and uncertainty of a possible cancer diagnosis, with less time between referral and hearing the outcome of diagnostic tests.
• Improved patient experience from fewer visits to the hospital.
• Potential to avoid invasive investigations and biopsy-associated risks such as infection
• Potential for improved survival by using mpMRI for early detection of clinically significant cancers.

Clinician benefits:

• Using a nationally agreed and clinically endorsed pathway to support quality improvement and reconfiguration of prostate cancer diagnostic services
• Working across primary and secondary care to ensure high quality referrals into a streamlined service that gets the patient to the right place, first time
• Improved ability to meet increasing demand and ensure best utilisation of highly skilled workforce
• Training and development opportunities for radiographers, radiologists, and urologists in performing, reporting, and interpreting mpMRI