The story that caught my eye in the papers this week was the news that prostate cancer is now the most common cancer in England with a 25 per cent rise in cases over the last five years.
Prostate Cancer UK shows that 55,000 men were diagnosed with prostate cancer in 2023. This is now more than the number of women who are diagnosed with breast cancer, which is still huge at 47,500.
This is important and worryingly it is also one of the most important cancers to identify early that we do not have a National Screening programme for and men are often in the dark about what the symptoms are and/or what screening is available. There are calls for the whole approach to prostate cancer detection to be overhauled and it should be and could be next week with the funding. If caught early, there is an almost 100 per cent survival rate, that changes dramatically for later diagnosis.
We certainly need men to be more aware of the symptoms of prostate cancer and understand that the risks are different for each man depending on race, age and family history.
For example, black men have a much higher risk of prostate cancer than white men. And men with a first-degree relative (father or brother) who had prostate cancer also have an increased risk. In fact these factors double the risk.
However, the test widely available is poor in terms of being a screening test. This is the PSA or prostate-specific antigen test. It is simple to do, just a blood test and if you are over 50 and a man you have the right to ask your GP to do one. But I always counsel men carefully; a man’s PSA level can go up if they have cancer, but it doesn’t always, especially early when it’s most important to catch it. Add to this that several other things make it go up; exercise, sex, ejaculating and infection. So the problem then arises as to what to do with a raised test. This is an important decision because some of the investigations that may follow a raised PSA, such as a prostate biopsy to see if the prostate has cancer, have side effects – pain, infection and erectile dysfunction to name a few. Some of these side effects may not be acceptable to the men faced with the decision to investigate their raised PSA.
A nation-wide MRI test must be rolled out to screen for prostate cancer, writes Renee Hoenderkamp
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There is a better test; an MRI. But the NHS can’t convince itself that they have the capacity or machines to screen all men over, say 50, nor that it is a cost-effective screen. In other words,they are not convinced that the cost of screening everyone saves enough money further down the line than the cost of treating men later on. It is however an accurate test with no side effects to the patient (apart from contrast allergy potentially) so for me, this is the test we should find a way to roll out.
So come on Wes Streeting; if you want to make meaningful changes in the NHS, taking prostate cancer seriously would be a great start.
In the meantime, guys, be vigilant and if you have any of the following symptoms, see your doctor immediately:
- Needing to pee more frequently, often during the night
- Needing to rush to the toilet
- Difficulty in starting to pee (hesitancy)
- Straining or taking a long time while peeing
- Weak flow
- Feeling that your bladder has not emptied fully
- Blood in urine or blood in semen
And if this does sound like you, don’t panic, as the totally benign but annoying enlargement of the prostate with age can cause the same symptoms, not only can this be treated it’s always better to check things out sooner and be safe than sorry.