We're proof prostate cancer screening can save men's lives - by spotting tumours with NO symptoms
Graham Dean is convinced he would not be here today to enjoy his retirement, or run around after his seven young grandsons, if he hadn't been lucky enough to receive an invitation through the post one day for a prostate cancer screening check at the age of 69.
'It may well have saved my life,' says Graham, now 71, a former petroleum engineer from Guildford in Surrey, who had no signs or symptoms of cancer prior to his diagnosis after being screened.
'I was fit and healthy and leading an active lifestyle – I had no reason to worry about cancer,' he says.
He was told he was lucky – the tumour had been caught early and had not yet spread beyond the prostate.
'Screening is a wonderful idea and I think it should be rolled out across the country as soon as possible, so many other men like me can also benefit.'
There are plenty more men like Graham up and down the UK – most don't have symptoms in the early stages of the disease – and there is nothing in place to catch the disease before it is too late.
It is to safeguard men like Graham that the Mail has launched a major campaign calling for a nationwide prostate cancer screening programme, similar to that for breast cancer – where all women over 50 are offered a mammogram (or breast X-ray) every three years – starting by targeting high-risk men.
Graham Dean, now 71, a former petroleum engineer from Guildford in Surrey, had no signs or symptoms of cancer prior to his diagnosis after being screened
The idea has won the support of Health Secretary Wes Streeting, who last week, writing in the Mail, said he hoped that the UK National Screening Committee – the panel of experts advising ministers on screening policies – would sanction routine checks when it completes a review of prostate cancer screening later this year.
But meanwhile, men's lives continue to be shattered by the news that they have a cancer that, in its earliest stages, can be simply treated – but if left can spread to the bones and beyond. Around 45 per cent of cases are diagnosed after the disease has spread.
Graham's good fortune is down to where he lives.
In 2022, doctors at the Royal Surrey County Hospital, in Guildford, set up a pilot prostate cancer screening programme to try to identify undetected cancers in high-risk men – those of Afro/Caribbean origin, with a family history of the disease or aged between 50 and 70 (ageing is a major risk factor).
Good Health recently reported how the programme, the first to combine prostate-specific antigen (PSA) blood tests (to measure levels of a protein in the blood that can rise when cancer is present) with MRI scans – then, where necessary, the men had a biopsy.
This trial uncovered hundreds of hidden cancer cases – potentially saving many lives.
Stephen Langley, a professor of urology at the Royal Surrey County Hospital – who led the screening trial – says he has seen countless patients diagnosed with prostate cancer who have repeatedly requested a PSA test, only to be denied one by their GP because they have no symptoms.
'I had a 70-year-old patient who said he had been trying for ten years to get a PSA test on the NHS but his GP kept saying no, as he had no symptoms – even though this is a largely symptomless disease.
'In the end, he had no choice but to lie to the doctor and pretend he did have symptoms – such as frequent urination – after which, the GP agreed to do a blood test. This showed his PSA level was about six times higher than it should be.
'He was diagnosed with cancer which was on the verge of spreading beyond the prostate – so he was very lucky and five years later he's still alive. But I would never recommend patients lie to their GP about symptoms.'
The charity Prostate Cancer Research estimates that initially focusing on men most at risk could mean an extra 775 cases a year are detected among those aged 45 to 89.
A survey reported in the Mail last week shows that 94 per cent of GPs back calls for a national scheme. Previous calls for a national screening scheme have been rejected on the grounds that the PSA test is not
sufficiently reliable and could mean many men undergo unnecessary biopsies when they don't have cancer.
But studies now show that giving men with a raised PSA an MRI scan – to look for evidence of a tumour – before they undergo a biopsy is a more accurate approach, as it means there is good evidence that cancer may be present before tissue samples are taken.
Graham, a keen jogger, had just retired when two years ago he received an invitation to have a PSA test at the Royal Surrey County Hospital.
'I assumed I'd been asked because of my age,' says Graham. Otherwise well he says 'looking back, the only possible sign of trouble was that my urine flow was not as strong as it used to be'.
Poor urine flow can mean the prostate is enlarged and pressing on the urethra.
This can be due to cancer but in many cases is because of a non-cancerous swelling in the prostate – known as benign prostatic enlargement – due to ageing, which affects half of all men over the age of 50.
However, Graham's blood test showed his PSA levels were marginally over the high threshold (at 4 nanograms per millilitre), so he was invited for an MRI scan.
This revealed a dark patch in the prostate which doctors feared could be cancer so they recommended an urgent biopsy. This confirmed there was cancer in about half of his prostate.
'It was quite a shock but things moved so quickly that I didn't really have time to take it all in,' says Graham.
Graham was given a choice – opt for surgery to remove the gland altogether (which carries a high risk of urinary incontinence and impotence) or brachytherapy, a form of radiotherapy where tiny radioactive seeds are implanted into the prostate to slowly kill off the cancer cells.
He chose the latter, as a less invasive option with fewer side effects.
'Just a few days after my operation [in autumn 2023]to have the radioactive seeds implanted, I was back running 5km, albeit a little slower than usual,' he says.
He has had regular six-monthly PSA blood tests ever since; his most recent test showed his PSA levels were down to 2ng/ml and doctors expect it to be even lower next time.
'Screening could well have saved my life – if I'd not been invited to take part my life would have changed completely,' he says.
Richard Flashman, 68, is also certain that screening saved his life, as he too had no symptoms.
Richard Flashman, 68, a retired engineer also from Guildford, took part in the Royal Surrey trial involving tens of thousands of men
'Absolutely no doubt about it,' says the retired engineer, also from Guildford and who took part in the Royal Surrey trial involving tens of thousands of men. 'I had no idea I had cancer. There were no symptoms and I was enjoying a very sporty, outdoor lifestyle – including playing lots of golf.'
But the checks, in December 2022, showed he had an aggressive tumour which could have spread rapidly.
Biopsy results revealed it was graded as a nine (out of a possible ten) on the Gleason score, which rates how aggressive the prostate cancer is and how likely it is to spread.
Richard chose radiotherapy and hormone treatment (to suppress cancer growth) rather than risk potential surgery side-effects.
'I'm really lucky they caught it early. I've since lost a friend to prostate cancer so I really believe a national screening programme is absolutely vital.
'I was just lucky enough to be living in the right area – but the sooner they roll this out across the whole of the UK the better.'
In the meantime men who want to be tested can ask their GP – but they may be turned down.
Professor Langley says some GPs stick religiously to guidance drawn up by Public Health England (now the UK Health Security Agency) not to mention the PSA test to men with no symptoms. But other practices he knows ignore this and proactively target at-risk men for testing.
'We are supposed to have a National Health Service so it should not be this variable,' he adds. 'It's so unfair.'
