‘I found out I had prostate cancer by chance – the new mammogram for men could save thousands'
When the letter from University College London Hospital landed on my doormat last spring, I almost threw it straight in the bin because I thought it was junk mail.
But it was looking for volunteers to be part of a clinical study on prostate cancer. It was the first lockdown and my work as a travel writer had all but dried up, so a few hours having an MRI scan, blood tests and hopefully some custard creams seemed more exciting than yet another online workout and learning Italian on my smartphone.
I’m not a hypochondriac, but my 83-year-old dad has had five cancers, including prostate, so I’ve always had a nagging “will it be me?” doubt. I got to 50 and my body began reminding me I’m no longer a spring chicken. The chance for a morning lie-in is now usually nixed by a need to get up and wee.
Nevertheless, my decision to volunteer in the UCLH trial was driven largely by a desire to do my bit for science as well as the fact that I had nothing much better to do. At 52, I’d been having an annual check for prostate cancer – PSA (prostate specific antigen) blood tests – for the past five years or so, and my most recent one in December 2019 had shown nothing irregular, so I wasn’t worried at all.
When it comes to cancer you hear the ‘it affects one in two people in their lifetime’ statistic, but you think it’s always going to be someone else in the family or that gangly bloke in accounts. It’s never going to be you. Until it is.
Several months later, as work bounced back a bit, I was outside the Morgan car factory in Worcestershire, about to put the keys into a spanking new £63,000 Plus-Four that I’d blagged for a weekend as part of a travel feature exploring the Malvern Hills. My mobile phone rang.
“Was this a good time for a quick word?” a voice from UCLH enquired matter of factly. The MRI had picked up “something, but it could just be a shadow” and I needed to come back for more tests. More tests led to a meeting, the meeting led to a biopsy and a biopsy led to another phone call.
I thought they were telling me everything was alright, nothing to worry about. But all of a sudden it dawned that they weren’t saying that. I can’t remember the exact words, just something like: “It’s about 6mm long; 90 per cent of it looks slow-growing but 10 per cent isn’t.”
I always thought I’d be pretty stoic about being told I had cancer. I wasn’t. I felt terrified and alone, even though I have a loving husband and family. And I was angry. Not at anyone, just generally irritated with life. Some people keep the news to themselves, but I told everyone. It just blurted out; I couldn’t stop myself. It was cathartic. Taxi drivers, our cleaner, the newsagent down the road, friends, family, neighbours.
According to Prostate Cancer UK, there are around 48,500 new prostate cancer cases in the UK each year and around 11,700 men die from the disease annually, making it a bigger killer than breast cancer.
Early detection is a life saver, but a PSA test isn’t at the forefront of most men’s minds when they feel fit and healthy. And the thought of a doctor twanging his rubber glove while exhorting you to bend over is enough for the most stoic of chaps to break out into a cold sweat.
The biggest problem with PSA tests, though, is that they tend to find too many non-aggressive cancers while missing the more aggressive – as I discovered. This is why there’s currently no national screening programme for prostate cancer (you can opt to have a PSA test with your GP, especially if you are considered at a higher risk, for example because of a family history).
But now comes the news that scientists at Imperial College London have developed a new 15-minute, non-invasive MRI scan called a Prostagram. Far more accurate than a PSA test, it has been hailed as a potential game changer, with trial results suggesting it could detect an extra 40,000 cases of the disease a year.
The hope is that the test will be rolled out as a ‘male mammogram’, modelled on breast cancer screening where women are routinely offered a scan every three years, which is credited with saving some 1,300 lives a year.
It’s also hoped it could mitigate two of the most common side effects of prostate cancer treatment – erectile dysfunction and incontinence – by avoiding unnecessary medical interventions for more benign cancers.
The Imperial College study screened 408 volunteers aged 50 to 69, applying both a PSA test and a Prostagram. In total 4 per cent of volunteers had aggressive prostate cancer, of which around 75 per cent were identified by Prostagram but only 41 per cent by PSA test. The team are now hoping to extend research to around 20,000 men and trying to raise the necessary £2m funding costs. They predict the scan could be rolled out nationally in five to 10 years.
“Prostate cancer is a disease that creeps up on you” says Dr David Eldred-Evans, senior clinical research fellow at Imperial. “While it does kill a lot of men, many also have non-aggressive cancer, which is why it’s said that for many, prostate cancer is a disease you often die with rather than from. That’s where our research is very interesting because its goal is to try and separate out the cancers that are likely to shorten life or cause problems in the long run from the non-aggressive cancers, which are very common and just part of being a man and getting older.”
Last November, I had a robotic radical prostatectomy. It’s strange to have a four-hour operation to remove the whole of your prostate when you don’t feel at all ill beforehand. The following three weeks were sore and uncomfortable but not painful. I had a catheter up my todger for 10 days, which was absolutely no fun whatsoever. The scars on my tummy were angry and itchy, partly because of a bad reaction to antibiotics. Incontinence has been real but is now pretty much under control, just the odd dripping tap. As for erectile dysfunction, well it’s early days but thanks to nerve-sparing techniques used during surgery I’m confident the empire will one day rise again.
The pathology report on the prostate showed the cancer was contained within what was removed. A fortnight ago, my first post-operation blood tests confirmed there is no need for follow-up radiotherapy. I’m officially in remission.
“See this as a turning point,” said one mate. “Either descend into being some grumpy old ‘why me?’ git or be thankful they caught it early and move on.”
I’m aiming for the latter. I plan to do a lot more walking in the glorious British countryside when we’re allowed. I can reflect on how lucky I’ve been that my cancer was picked up and treated before it spread. Hopefully the Prostagram will allow an equally positive outcome for thousands more men in the future.
For advice and information on prostate cancer visit prostatecanceruk.org or speak to their specialist nurses on 0800 074 8383. You can follow Will Hide on Twitter @Willhide
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