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<p>The NHS England Specialised Commissioning team introduced nationally developed
service specifications for a range of areas, including prostate cancer, during 2013-14.
Prior to 2013, prostate cancer was routinely commissioned by primary care trusts,
and as such an assessment of the changes in the level of access to prostate cancer
treatments since 2010 is not technically feasible.</p><p> </p><p>Routinely commissioned
treatments for prostate cancer are: (i) radical prostatectomy; (ii) radical external
beam radiotherapy; and (iii) radical brachytherapy. In addition, NHS England routinely
commissions systemic treatments for prostate cancer, including hormone therapy and
chemotherapy.</p><p> </p><p>The National Institute for Health and Care Excellence
(NICE) has published technology appraisal guidance which recommends docetaxel (Taxotere)
for hormone-refractory prostate cancer and abiraterone (Zytiga), in combination with
prednisolone or prednisone, for castration-resistant metastatic prostate cancer previously
treated with one docetaxel-containing regimen. NICE is also currently developing technology
appraisal guidance on a number of other drugs for prostate cancer.</p><p> </p><p>National
Health Service commissioners are legally required by regulations to fund those treatments
recommended by NICE in its technology appraisal guidance.</p><p> </p><p>Five-year
survival rates improved from around 42% in the late 1980s to 79.7% in 2007 (currently
80.2% according to data for 2006-2010 published in October 2012) due in part to the
effects of increased Prostate Specific Antigen testing and earlier detection. However,
survival rates in England are still lagging behind comparable countries in Europe.</p><p>
</p><p>Cancer Research UK has estimated that men with advanced, incurable prostate
cancer treated in trials or under drug access schemes at the Royal Marsden Hospital
survived on average 41 months, compared to between 13 and 16 months 10 years ago.</p><p>
</p><p>The Government's Mandate to NHS England sets out an ambition to make England
one of the most successful countries in Europe at preventing premature deaths from
all cancers, including prostate cancer. Cancer indicators in the NHS Outcomes Framework
and the Public Health Outcomes Framework will help NHS England to assess progress
in improving cancer survival and mortality for men with prostate cancer.</p><p> </p>
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