CANCE R DIAGNOS TICS
‘Trexit’ is not limited to South East London – it’s a national initiative, designed to support and drive adoption of LA TP across the NHS. As such, advocates have also developed a BAUN accredited national training programme to increase the number of NHS nurses skilled in LA TP. With the consensus and support of leading urologists, clinical nurse specialists and thought leaders in prostate cancer diagnosis, TRexit is building a national momentum that is helping other hospitals, such as those across the South West Cancer Alliances, replicate that SEL success.
The South West eradicates TRUS biopsies
During 2020, the South West of England has widely adopted the PrecisionPoint Transperineal Access System. Since January last year, Mr Stefanos Bolomytis and Professor Raj Persad, consultant urologists at North Bristol NHS Trust, and Mr Angus Maccormick, Somerset NHS Foundation Trust, have established a regional service for the roll- out of transperineal biopsies under local anaesthetic (LA TP), with the initiative
supported and part-funded by the South West Cancer Alliance’s regional fund. To date, 40 consultants and clinical nurse specialists across the region have been trained, with outcomes including an overall cancer detection rate of 60.7%, significantly reduced incidence of sepsis, as well as total theatre time and overall cost savings. Indeed, initial audit data suggests theatre time savings of 450 hours and the potential to achieve significant income and resource benefits compared to the traditional TRUS method, are readily achievable. Professor Persad comments: “Our data highlights the clear benefits of LA TP over TRUS biopsy methods, which include 0% sepsis from the biopsies undertaken at Southmead Hospital and improved cancer detection. Traditional prostate biopsies involve using a transrectal probe. We know this would put some men off the procedure. This is a thing of the past at Southmead where biopsies are now undertaken virtually painlessly through the ‘perineum’.” Since January 2019, when Mr Bolomytis
and Prof. Persad first started using the PrecisionPoint Transperineal Access System at the Bristol Urological Institute, the team has carried out 1100 LA TP biopsies. Beatriz Mora is a surgical care practitioner at the Bristol Urological Institute at Southmead Hospital, who has undertaken 120 of these LA TP biopsies during 2020. She explains: “My role is both an interesting and evolutionary one. I work in clinical practice as a member of the extended surgical team and perform surgical intervention, pre- operative care and post-operative care under the direction and supervision of a consultant surgeon. It’s been a privilege to have the
AUGUST 2021
opportunity to enhance patient care and support the department in maintaining our prostate cancer services through LA TP during the COVID-19 pandemic and lay a foundation for a better prostate cancer pathway moving forward.”
The South West Cancer Alliances are made up of the Peninsula Alliance covering Devon and Cornwall and the Somerset, Wiltshire, Avon and Gloucestershire Alliance who aim to have fully eradicated TRUS biopsies by the end of the year, with adoption of LA TP in all 13 Acute Trusts. Sarah-Jane Davies, programme manager
at Peninsula Cancer Alliance, who has supported the adoption of the regional LA TP service across the south-west region, adds: “The significant benefits that transperineal biopsies offer over TRUS have been recognised for some time. The challenge has been to adopt them within an outpatient setting, something that is now achievable with the latest PrecisionPoint methodology. We are delighted of the progress the south- west has made in making this technology available to patients, healthcare professionals and the local healthcare economy.”
CSJ
References 1
https://www.thetimes.co.uk/article/shocking-rise- in-cancer-patients-not-being-treated-due-to-covid- 19-concerns-nhs-england-data-shows-bj50db80d
2
https://www.thetimes.co.uk/article/shocking-rise- in-cancer-patients-not-being-treated-due-to-covid- 19-concerns-nhs-england-data-shows-bj50db80d
3
https://www.clinicalservicesjournal.com/ story/35340/70-of-surgical-professionals- concerned-about-backlog?utm_
source=Clinical%20Services%20Journal&utm_ medium=General%20News&utm_campaign=1479
WWW.CLINICALSERVICESJOURNAL.COM l 31
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88
