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Practice Guidelines

Diagnosis and treatment of prostate cancer: summary of NICE guidance

BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.39498.525706.AD (Published 13 March 2008) Cite this as: BMJ 2008;336:610

This article has a correction. Please see:

  1. John Graham, lead consultant in clinical oncology1,
  2. Mark Baker, lead cancer clinician2,
  3. Fergus Macbeth, director3,
  4. Victoria Titshall, project manager3
  5. on behalf of the Guideline Development Group
  1. 1Taunton & Somerset NHS Foundation Trust, Musgrove Park Hospital, Taunton TA1 5DA
  2. 2Leeds Teaching Hospitals NHS Trust, St James’s University Hospital, Leeds LS9 7TF
  3. 3National Collaborating Centre for Cancer, Cardiff CF10 3AF
  1. Correspondence to: J Graham john.graham{at}nhs.net

Why read this summary?

Prostate cancer is one of the commonest cancers in men. Each year there are about 35 000 new cases in England and Wales and over 9000 deaths. The clinical course can extend over many years and often involves many different healthcare professionals. Evidence exists of practice variation around the country and of patchy availability of certain treatments and procedures. This article highlights a selection of the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on the diagnosis and treatment of prostate cancer.1

Recommendations

NICE recommendations are based on systematic reviews of the best available evidence. When minimal evidence is available, recommendations are based on the guideline development group’s opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets.

Informed decision making

Men with prostate cancer can be faced with multiple treatment choices over many years. Healthcare professionals should:

  • Adequately inform men with prostate cancer and their partners or carers about the effects of prostate cancer and the treatment options on their sexual function, physical appearance, continence, and other aspects of masculinity. [Based on evidence from qualitative studies and the experience of the Guideline Development Group (GDG)]

  • Support men and their partners or carers in making treatment decisions, taking into account the effects on quality of life as well as survival. [Based on the experience of the GDG]

  • Ensure that mechanisms are in place to allow men with prostate cancer and their primary care providers to gain access to specialist services throughout the course of their disease. [Based on the experience of the GDG]

Diagnosis

  • To help men decide whether to have a prostate biopsy, discuss with them their prostate specific antigen (PSA) level, digital rectal examination findings, age, black African or black Caribbean ethnicity (associated with …

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