A lack of evidence is behind the NHS' decision to withhold a breakthrough prostate cancer drug from patients who have already been treated using another new generation drug, Nice said.
A spokeswoman for Nice said the committee were unable to "draw any conclusions" about what would happen if "milestone" enzalutamide was used by prostate cancer sufferers who had also taken abiraterone.
In the trial data provided by the manufacturer of enzalutamide none of the patients had received previous treatment with abiraterone, therefore the committee was not able to draw any conclusions about the effectiveness of enzalutamide after previous abiraterone treatment, and this is reflected in the recommendations.
We would welcome any additional data the manufacturer of enzalutamide can provide.
Prostate cancer medicine hailed as a "milestone" breakthrough may not be available to every patient after a revision of the drug guidelines, according to the NHS.
Men in England who have already been treated with a new-generation cancer drug would not be eligible for Enzalutamide, according to the National Institute for Health and Care Excellence (Nice).
Nice, the public body which decides the cost-effectiveness of medicines for NHS patients, said the new drug should not be used by patients who had already taken abiraterone.
Enzalutamide blocks molecular signals driving prostate cancer and improved survival by 30% in men who had not undergone chemotherapy.
A further 80% of men with advanced cancer had the progression delayed, even if the tumour had failed to respond to other treatments.
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Prostate cancer will become the most common cancer in the UK "in the next 15-20 years".
"All the statistics say that prostate cancer is currently the most common cancer among men, it's about as common as breast cancer. Within the next 15-20 years it will be the most common cancer in this country.
"For the majority of the men who have it, they don't have any symptoms. That is the very reason why you need to go to the doctor, particularly when you get close to 50 and see if the test is right for you."
Only 10% of GPs discuss prostate cancer with their male patients, often failing to initiate the discussion, a poll found.
The survey of 500 GPs across the UK found many men were risking their health by not discussing the cancer with their doctor, Prostate Cancer UK found.
The risk of developing prostate cancer increases with age, typically from a man's fifties onwards.
Each year, around 41,000 men in the UK are diagnosed with prostate cancer and 11,000 die from the disease.
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Professor Mark Baker, director of Nice's Centre for Clinical Practice, says that the "surveillance" protocol for men with slow-growing prostate cancer would involve "regular check-ups" instead of "radical treatment".
Prostate cancer can be very slow growing and whilst many men will have a cancer that won't cause them any harm in their lifetime, nearly 10,000 men still die every year in England and Wales.
The updated guideline includes a number of new recommendations on the swift diagnosis and treatment of different stages of the disease and a new protocol for men who choose active surveillance, which involves regular check-ups to see if and how the cancer is developing, rather than radical treatment.
- Prostate cancer is the most common cancer in men
- It accounts for more than a quarter of all male cancer diagnoses in the UK
- It is predominantly a disease of older men (aged 65–79 years)
- There is a higher incidence of and mortality from prostate cancer in men of black African-Caribbean descent
Some men with prostate cancer should be offered "surveillance" rather than treatment, according to new guidance from the National Institute for Health and Care Excellence (Nice).
Doctors treating sufferers deemed to have "intermediate" or "low" risk prostate cancer should consider offering monitoring rather than radical surgery or radiotherapy, the guidance says.
According to Nice, prostate cancer can be "slow growing" and many men will have cancer that will not cause them any harm in their lifetime.
Meanwhile treatment options, including surgery and radiotherapy, can have "serious side effects", such as erectile dysfunction and fertility and continence problems.
Prostate Cancer UK has said more complex research needs to take place so the link between omega-3 and the risk of prostate cancer can be fully understood.
However Dr Iain Frame said further research needed to take place before any conclusions were reached:
Although this report claims to add to existing research which has indicated that a diet rich in this nutrient can also be associated with an increased risk of developing prostate cancer, much larger and more complex studies will need to take place before we will fully understand how the risks of a diet high in omega-3 balance against those benefits.
Therefore we would not encourage any man to change their diet as a result of this study, but to speak to their doctor if they have any concerns about prostate cancer."