Sussex man calls for changes to prostate cancer monitoring
Robin Porter spent 13 years safely living with low-risk prostate cancer under active surveillance and says updating NICE guidelines would ensure more men across the UK can avoid unnecessary surgery
Prostate Cancer UK is calling for an immediate update to outdated NICE guidelines on “active surveillance” – a form of monitoring for men with low-risk prostate cancer – warning that the current rules are inconsistent, out of step with NHS advice, and could be leading thousands to undergo treatment they do not need.
The charity says modern diagnostic tools and monitoring methods mean more men can safely delay or avoid treatment altogether, but the official guidance has not kept pace. Its new analysis suggests that if the NHS advice introduced last year was followed nationwide, up to 5,000 more men each year could avoid unnecessary treatment and the harmful side effects it can bring.
A freedom of information request by Prostate Cancer UK found only 24% of hospitals rely solely on NICE guidance, with 35 creating their own rules for active surveillance. The charity says this is causing a postcode lottery in care and confusion among urologists.
Under current NICE guidelines, active surveillance – regular blood tests, scans, and check-ups instead of immediate surgery or radiotherapy – is only recommended for men with the lowest-risk prostate cancer. Updated NHS advice, issued in 2024, also recommends it for the next lowest-risk group, where eight in 10 men still show no sign of cancer spread within five years.
Robin Porter, 79, from Sussex, knows first-hand how valuable active surveillance can be. Diagnosed in 2006, he was initially advised to have surgery, but sought a second opinion. “When you hear the word cancer, you think you might have to have very unpleasant treatment,” he said. “But I was told I could be monitored, and I was able to carry on with my life and my work without surgery or the side effects that can come with it.”
Robin spent 13 years on active surveillance before needing treatment. “All that happened was I had regular blood tests and scans. So long as there were no signs of the cancer progressing, I could continue as normal,” he said. “It meant I could keep fit, enjoy cycling, and live life without the impact of unnecessary treatment.”
He believes updating the NICE guidelines would make a significant difference for men across the UK. “It would create more consistency so everyone has equal chances of active surveillance,” he said. “It’s a very good option for many men and can help them maintain their health and enjoy their lives while still being closely monitored.”
Prostate Cancer UK says the lack of an update means some hospitals are still treating all men with low-risk prostate cancer in the same way, as recommended by the outdated guidance, rather than tailoring care to the individual’s cancer risk. This, they say, means some men may undergo surgery or radiotherapy when they could have been safely monitored.
Robin says that during his years on active surveillance, he saw treatments and technology improve – something that also worked in his favour. “If you can delay treatment, it means when you do need it, the techniques might be better,” he said. “Updating the guidelines now would give men across the country that same opportunity.”
The charity says prostate cancer is the most common cancer in men, with one in eight diagnosed in their lifetime, rising to one in four for Black men. It believes that ensuring equal access to active surveillance will not only improve quality of life for many, but also help the NHS make best use of resources.
Robin added: “It will ultimately improve the lives of men and enable them to live a fulfilling and useful life while still getting the care they need.”