§ Mr. McWalterTo ask the Secretary of State for Health what action he has taken to improve the identification and treatment of male cancers; what assessment he has made of the use of gene therapy in such treatment; and what plans he has to support research in this area. [19504]
§ Mr. BoatengThe two major male cancers are testicular and prostate cancer.
Raising awareness of cancer among general practitioners and patients and encouraging them to be alert that symptoms may be due to serious disease such as cancer is an important aspect of the Government's policy 127W for cancer services set out in "A Policy Framework for Commissioning Cancer Services", copies of which are available in the Library.
In September 1995, the Imperial Cancer Research Fund jointly with the Department of Health launched a campaign to encourage testicular awareness through publication of a leaflet entitled "A Whole New Ball Game" so that testicular cancer could be detected early. There have been marked improvements in the treatment of testicular cancer over the last 20 years and now over 95 per cent. of patients can be cured.
Professional bodies in the United States of America and the United Kingdom have published guidelines on treatment of prostate cancer. The Department of Health funded Clinical Oncology Information Network, jointly with the British Association of Urological Surgeons, has produced some further guidelines which are currently out for consultation and are due to be published next year.
The National Screening Committee has recommended that there is currently no case for a national screening programme for prostate cancer. This recommendation has been accepted by Ministers. There is at present no medical evidence to suggest that a screening programme for testicular cancer should be introduced.
Gene therapy for cancer is still at the research stage. At January 1997, 10 gene therapy trials involving cancer were approved in the UK by the Gene Therapy Advisory Committee. None of these involve testicular or prostate cancer. However all cancer research has the potential to lead to developments in the treatment of other forms of cancer.
The main agency through which the Government support medical and clinical research is the Medical Research Council (MRC). The MRC is an independent body which receives its grant-in-aid from the Office of Science and Technology, which is part of the Department of Trade and Industry. The Council is currently co-ordinating four trials in the area of testicular cancer. These are: a randomised trial of two schedules of radiotherapy for stage 1 seminoma of the testis, following orchidectomy; a randomised trial of single agent carboplatin with radiotherapy in the adjuvant treatment of Stage 1 seminoma of the testis, following orchidectomy; a randomised trial of 3 x Bleomycin, Etoposide and Cisplatin (BEP) versus 3 x BEP + 1 x Etoposide and Cisplatin (EP) and the five day schedule versus three days per cycle in good prognosis germ cell cancer; a retrospective study of second cancers following radiotherapy for stage 1.
The Council is co-ordinating two trials in the area of prostate cancer. These are: a double blind placebo-controlled trial of oral sodium clodronate for locally advanced prostatic adenocarcinoma; a double blind placebo-controlled trial of oral sodium clodronate for metastatic prostatic adenocarcinoma.
The Council have recently awarded two grants in the area of male cancers with a total value of £50,000. Research into male cancers is underpinned by a significant amount of basic research relevant to all cancers.
128WWhile the Council does not support any work on gene therapy in the treatment of male cancers, it does provide support for more basic research into gene therapy which will underpin and inform future more applied work in the area.
The Department of Health's Policy Research Programme (PRP) is currently undertaking a systematic review of minimally invasive therapy for benign prostatic hyperplasia and cancer. The study is being undertaken at the University of Newcastle at a cost of some £40,000.
A study into the development and clinical evaluation of trans-rectal ultrasound devices for thermotherapy of benign prostatic hyperplasia is currently being undertaken at the Royal Postgraduate Medical School at a cost of £130,000.
In addition another study, a mortality study of cadmium exposed workers with particular reference to lung and prostatic cancer, was completed last year and has reported. The study was undertaken at Imperial College at a cost of £32,000.
The National Health Service Research and Development Programme's Health Technology Assessment (HTA) Programme has also undertaken two studies into prostate cancer.
These are: a systematic review of detection, management and screening for prostatic carcinoma, at a cost of approximately £54,000; a review of evidence on the cost-effectiveness of different strategies for detecting and managing prostatic carcinoma, at an approximate cost of £13,000.
These two studies have reported. The HTA Programme is developing work on treatment for the spectrum of prostate cancers likely to be revealed by a screening programme. If more successful treatments can be developed it may be appropriate to look again at the potential effectiveness of introducing a screening programme at a future date. The HTA Programme is also funding three projects on treatment for benign prostatic hyperplasia, costing £785,000 over four to five years.
The NHS R and D Cancer Programme has funded a systematic review of the early natural history of prostate, skin and oral cancers at a cost of £46,000.