A new test will screen men for prostate cancer even if they have no symptoms

Men will undergo a prostate-specific antigen test, which looks for elevated levels of the PSA protein in the blood.  An elevated PSA may indicate the presence of prostate cancer cells [File photo]

The UK’s first prostate cancer screening program is being launched today in an effort to reduce the number of deaths from the disease, Good Health can exclusively reveal.

Up to 12,000 men in the south of England will be tested for the disease over the next year as part of a scheme which could be rolled out across the UK if it is successful in detecting ‘hidden’ cancers in men without symptoms. .

Men will undergo a prostate-specific antigen test, which looks for elevated levels of the PSA protein in the blood. An elevated PSA may indicate the presence of prostate cancer cells.

Currently, the PSA test is only offered to men who have possible symptoms of prostate cancer (such as urinating more often or blood in the urine) or those with a strong family history of the disease.

The project, which has NHS England funding of around £750,000, is led by the Surrey and Sussex Cancer Alliance, a body made up of NHS doctors, charities and cancer patients which oversees cancer care in both counties.

All men aged 50 to 70 in the new scheme’s catchment area will have the opportunity to attend their local GP’s surgery for a PSA test.

Men will undergo a prostate-specific antigen test, which looks for elevated levels of the PSA protein in the blood. An elevated PSA may indicate the presence of prostate cancer cells [File photo]

But priority will go to those who are at greater risk, such as those of Afro-Caribbean origin (at greater risk because they have more genetic mutations that predispose them to the disease) or men who have a close relative who was also affected. . In these groups, men over 45 will be targeted.

The Alliance is working with more than 50 GP practices in the area to identify those who will be offered the PSA test.

“We hope to save a lot of men’s lives,” says Professor Stephen Langley, director of urology at the Royal Surrey County Hospital in Guildford and clinical lead for the Surrey and Sussex Cancer Alliance.

“The cure rate for prostate cancer that is detected early is high, up to 90 percent.

“But when it has spread to other parts of the body, a cure is usually not possible.

“And we have to address the impact of the Covid-19 pandemic, because in our region alone we’ve seen referrals for suspected prostate cancer drop to just 60 to 70 percent of the normal rate , because men cannot see their doctors.

“We have a duty to do what we can to try to help men who may have cancer and don’t know it.”

Prostate cancer affects around 47,000 men a year in the UK and kills almost 12,000 each year.

If caught early and before it has spread beyond the prostate, there is a good chance of survival. But in about 10 percent of cases it has already spread to other organs by the time it is picked up, after which the chances of living beyond two years are slim.

Treatment for these men simply aims to slow tumor growth with chemotherapy or by reducing levels of testosterone, a hormone that helps prostate cancer cells grow.

All men aged 50 to 70 in the new scheme's catchment area will have the opportunity to attend their local GP's surgery for a PSA test. [File photo]

All men aged 50 to 70 in the new scheme’s catchment area will have the opportunity to attend their local GP’s surgery for a PSA test. [File photo]

One of the reasons thousands of men each year are diagnosed only when the disease has spread is because, in the early stages, few have the familiar symptoms, such as urinating more often, difficulty urinating, urinary flow weak or blood in the urine or semen. .

Actor and comedian Stephen Fry revealed that he had no signs of illness when he was diagnosed with prostate cancer in 2017. He later said: “I was pretty much out of it, I didn’t have any symptoms to indicate that anything was wrong.” Fortunately, it was caught early, making it more treatable.’

Elevated PSA levels may indicate the presence of prostate cancer cells. However, this can also be due to a number of other factors, such as a urinary tract infection, an enlarged prostate, vigorous exercise or having had sex in the previous 48 hours.

As a result, the PSA test has not been considered accurate enough to warrant its use in a national prostate screening program, such as breast and cervical cancer for women.

The UK’s National Screening Committee, which advises the government on which diseases to routinely screen for, has in the past ruled out using the PSA test for a national screening program because it says it is not reliable enough.

The concern was that if a national scheme were to go ahead, thousands of men with high PSA readings could end up enduring painful biopsies (where tiny samples of prostate tissue are removed to check for a tumor) when in fact they are not they had cancer all, or had a tumor that grew so slowly that it was very unlikely to kill them.

Some prostate tumors are aggressive and grow quickly, while others progress so slowly that the patient almost always dies of something else before it ever becomes a problem.

These two types are often colloquially known as “tigers” and “cats”.

Under the pilot scheme in Surrey and Sussex, men with high PSA readings will only undergo a biopsy once they have also had an MRI (which produces detailed images of the prostate) to give vital clues as to whether it is cancer , how big is the cancer. and if it appears to be at risk of spreading.

“PSA is not a perfect test and has had a bad press over the years,” says Professor Langley.

“But some large studies suggest that it is almost as effective as breast cancer screening in terms of detecting early cancers.”

The European Prostate Cancer Screening Study, a long-running investigation into the value of PSA testing, found it reduced deaths by up to 22% over an 11-year period, according to results published in The Lancet in 2014.

“The men in our pilot project will have a biopsy only if the MRI results warrant it; we hope to distinguish not only that the PSA rise is due to cancer, but also to separate the tigers from the cats at an early stage and, in the first time. process, reduce the rate of unnecessary biopsies by up to 30 percent,” says Professor Langley.

“One in eight men will get prostate cancer at some point in their lives. ‘

Men in the program will first be asked to submit a urine sample to rule out an infection that could give a falsely high PSA reading.

If their PSA levels have risen by then, above 3ng/ml, they will be referred straight to their local hospital, rather than having to go back to their GP for a referral for an MRI.

“We’re streamlining the way for these men to be referred for rapid assessment within two weeks,” says Dr. Ed Bosonnet, director of primary care at Medefer, a digital health company involved in the project.

The hope is to offer men both urine tests and PSA tests, using a finger-prick blood test similar to those used in diabetes, that they can do at home. The idea is that they could then log their readings on a website.

Chiara de Biase, director of support and influence at Prostate Cancer UK, said the charity is “very supportive of this initiative, which will help early diagnosis by targeting those most at risk of prostate cancer”.

“Unfortunately, there are still thousands of men who have not come forward for a diagnosis since the start of the pandemic. This is the kind of initiative we would like to support the rest of the country to help find these men and detect more cancers earlier.”

5 of the best long-life salads

Long-life salads can be a better alternative to sandwiches and chips at lunchtime. Here, Sophie Medlin of City Dietitians and president of the British Dietetic Association picks five of the best.

Rio Mare Insalatissime Beans and Tuna

160g, £3.80, ocado.com

Rio Mare Insalatissime Beans and Tuna

Rio Mare Insalatissime Beans and Tuna

Per 100 g: Calories, 205; saturated fat, 1.7 g; protein, 11.5 g; fiber, 4 g; sugar, 1 g; salt, 1.5 g

With cannellini beans, green beans, carrots, chickpeas, peppers and olives, this counts as one of your five a day. Cannellini beans are a good source of calcium, while tuna provides a useful amount of protein.

But you’ll get 2.4g of salt in one serving, 40 percent of your daily limit. Serve with a small potato for a heartier meal.

Taste: a bit bland.

Salad of five Neapolitan beans with vinaigrette

410g, £1, sainsburys.co.uk

Per 100g: Calories, 124; saturated fat, 0 g; protein, 7.1 g; fiber, 6.2 g; sugar, 2.1 g; salt, 0.72 g

The five different beans in this can (kidney, black eye, borlotti, navy, and lima), along with corn, herbs, and seasonings, are great for your gut bacteria. Beans contain polyphenols, plant compounds that support heart health. Divide into two portions and eat with a crisp green salad.

Taste: Pleasant dressing and vinegar.

Jamie Oliver delicious Moroccan salad

Jamie Oliver delicious Moroccan salad

Jamie Oliver delicious Moroccan salad

250g, £2.30, sainsburys.co.uk

Per 100g: Calories, 169; saturated fat, 0.7 g; protein, 5.5 g; fiber, 6.6 g; sugar, 1.9 g; salt, 0.3 g

This bag contains equal amounts of precooked bulgur wheat, spelled, and chickpeas. Bulgur is an excellent source of fiber, important for heart and gut health.

Spelled is a source of iron, while chickpeas provide useful amounts of choline for brain health. Reasonably low in salt.

Taste: Lemon with mild spice taste, a little fatty.

John West On the Go Salmon Bulgur Wheat Salad

220g, £2.50, asda.com

Per 100g: Calories, 138; saturated fat, 0.6 g; protein, 12 g; fiber, 3.4 g; sugar, 6.2 g; salt, 1 g

This high-protein, low-calorie salad has a good variety of vegetables. You’ll get 26g of protein from the salmon, as well as brain-healthy omega-3 fats. But there is the equivalent of three teaspoons of sugar.

Taste: A little dry.

Quinola Mediterranean integral quinoa

Quinola Mediterranean integral quinoa

Quinola Mediterranean integral quinoa

250g, £1.90, ocado.com

Per 100g: Calories, 155; saturated fat, 0.5 g; protein, 4.5 g; fiber, 4.8 g; sugar, 1.9 g; salt, 0.42 g

Quinoa provides essential amino acids, heart-healthy fats, slow-release carbohydrates, and is a great source of fiber.

Flavored with tomato and olives, serve straight from the package.

Flavor: Powerful olive flavor.

Mandy Francis

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