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Thursday, March 7, 2019

Llan man's cancer battle debated by AMs

* Stuart Davies spearheaded the prostate cancer campaign. 

A campaign by a Llangollen man for equal prostate cancer treatment to be available across the country has been debated in the Welsh Assembly.

Former county councillor Stuart Davies paid Betsi Cadwaladr University Health Board (BCUHB) nearly £900 for a multi-parametric MRI (mpMRI) scan when a cancer that he'd beaten several years ago returned 18 months ago.

The mpMRI is a specific type of MRI scan that can give more detailed images of the prostate than a regular MRI scan.

The scan was recommended to Mr Davies by the health board as a way of specifically deciding upon the correct treatment for his cancer. After receiving the scan in 2017 he was shocked to learn that it is offered for free by other health boards in Wales.

Before the petition was launched, just three of the seven health boards in Wales, offered mpMRI before biopsy and only one board provided to a standard high enough to safely rule men out of biopsy. This meant men in four health boards did not have access to mpMRI as a diagnostic test, unless they paid to have it done privately.

Yesterday Assembly Members debated the petition and North Wales AM  Mark Isherwood urged the Welsh Government to act on the campaigners' calls.

Wrexham Maelor Hospital's urology unit is one of 11 units across England and Wales that took part in the prostate MRI imaging study ‘PROMIS’ trial to discover improved ways of diagnosing prostate cancer.

Although the results showed that 93 per cent of aggressive cancers were detected by using the mpMRI scan to guide the biopsy compared with just 48 per cent where only a Transrectal ultrasound guided (TRUS) biopsy was carried out, men in North Wales have had to fund the scans themselves because they were not provided or funded by the health board in North Wales. 
Speaking in the debate, Mr Isherwood said that last March's announcement by NHS England that it was launching a one-stop service using MRI techniques to revolutionise prostate cancer treatment and slash the time taken for a diagnosis there was a game changer, that men’s lives here are being put at risk and that patients across Wales should not be left behind.
He said: Last December, NICE issued new draft guidance recommending pre-biopsy mpMRI for suspected Prostate Cancer, with final guidance expected next month.

“In January, the Health Minister wrote to members stating that he had asked all Health Boards to work with the Welsh Urology Board to ensure that they have full implementation plans within one month of this.
“In the same letter he stated that “Health Boards have confirmed that at present they deliver care in line with current NICE Guidance”.

“North Wales patients subsequently reiterated that care was not delivered in line with current NICE Guidance in their cases.
“North Wales Community Health Council stated that the Health Board have consistently declined to produce proof that they did any scans for men with rising PSA following a negative biopsy – and that they are co-ordinating refunds to all of their clients who did not receive scans in line with the 2014 guidance.

“They also state that their correspondence with the Health Minister gives them no comfort that he will intervene if they make the same decision on the pre-biopsy mpMRI guidance."

Mr Isherwood added: “This petition’s sponsor, Stuart Davies, states that interim arrangements should be put in place now so that men do not put their lives at risk, that although patients pay approximately £900, the cost to the NHS at Wrexham’s Spire Hospital is only £365 – and that men contacting the campaign say that they are either waiting for it to become free or are taking out loans to pay for their scan. 
“Last December, I attended a meeting with Mr Davies, the Health Board and Community Health Council, at which the Health Board apologised and offered to refund the money men had paid for scans.

“However, only this week, a constituent received a letter from the Health Board stating that “although current clinical advice suggests that the use of full diagnostic mpMRI may be beneficial … this has not yet been supported by NICE.
“Noting, however, that NICE has now backed mpMRI scans as a cost effective first-line investigation, Tenovus Cancer Care have called on the Welsh Government to ensure that mpMRI is available across Wales, stating that it is not available at Betsi Cadwaladr, Hywel Dda or Swansea Bay, and not available at PROMIS standards in Cardiff and Vale.
“As Prostate Cancer UK states, mpMRI revolutionises Prostate Cancer diagnosis, so let's listen to the experts with lived experience. These men have been telling the truth from the very beginning."

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