Up to 12,000 men in the South of England will be screened for the disease in the next year or so as part of a program which could be rolled out across the UK if it proves successful in detecting ‘hidden’ cancers in men with no symptoms. . Men will have a prostate-specific antigen test, which looks for elevated levels of the PSA protein in their blood. Elevated PSA may indicate the presence of prostate cancer cells. The PSA test is currently usually only offered to men who have possible symptoms of prostate cancer (such as more frequent urination or blood in their urine) or those who have 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 the two counties. All men aged 50 to 70 in the new scheme’s catchment area will have the opportunity to attend their local GP surgery for a PSA test. Men will have a prostate-specific antigen test, which looks for elevated levels of the PSA protein in their blood. Elevated PSA may indicate the presence of prostate cancer cells [File photo] However, priority will be given to those likely to be at greater risk, such as those of Afro-Caribbean descent (at greater risk because they have more genetic mutations that predispose them to the disease) or men who have a close family member who is also affected . Men over 45 will be targeted in these groups. The Alliance is working with more than 50 GP practices in the region 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 detected early is high – up to 90 percent. “But once it has spread to other parts of the body, it is usually not curable. “And we have to deal with the impact of the Covid-19 pandemic, because in our region alone we’ve seen referrals for suspected prostate cancer drop to 60 or 70 percent of the normal rate because men can’t see doctors. “We have a duty to do everything 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 a year. If caught early and before it spreads 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’s caught, after which your chances of living more than two years are slim. Treatment for these men is simply aimed at slowing 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 be offered the opportunity to attend their local GP surgery for a PSA test [File photo] One of the reasons thousands of men each year are only diagnosed when the disease has spread is because, in the early stages, few have the familiar symptoms – such as more frequent urination, difficulty urinating, weak urine flow, or blood in the urine or semen. Actor and comedian Stephen Fry revealed that he had no signs of illness at all when he was diagnosed with prostate cancer in 2017. He later said: “I was pretty upset – I had no symptoms to suggest 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 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 that for breast and cervical cancer for women. The UK’s National Screening Commission, which advises the government on which diseases should be screened for regularly, has previously 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 program went ahead, thousands of men with high PSA readings could end up having painful biopsies (where tiny samples of tissue are removed from the prostate to check for a tumor) when in fact they did not have cancer or had a tumor that was growing so late that it was highly unlikely to kill them. Some prostate tumors are aggressive and grow quickly, while others grow so slowly that the patient almost always dies of something else before it becomes a problem. These two types are often colloquially referred to as “tigers” and “pussy”. Under the Surrey and Sussex pilot scheme, men with elevated PSA readings will only undergo a biopsy after undergoing an MRI (which produces detailed images of the prostate) to give vital clues as to whether it is cancer, how big the Cancer. and if it appears to be in danger of spreading. “PSA is not a perfect test and has had a bad press in recent years,” says Professor Langley. “But some large studies suggest it’s just as effective as breast cancer screening at detecting early cancers.” The European Prostate Cancer Screening Study, a long-term investigation into the value of the PSA test, found it reduced deaths by up to 22 percent over an 11-year period, according to results published in The Lancet in 2014. “Men in our pilot project will only be biopsied if MRI results warrant it — we hope to distinguish not only that elevated PSA is due to cancer, but to separate the tigers from the pussies at an early stage and, in the process, reduce the rate of unnecessary biopsies up to 30 percent,” says Professor Langley. “One in eight men will develop prostate cancer at some point in their lives. ‘ Men participating in the program will first be asked to submit a urine sample to rule out an infection that can give a falsely high PSA. If they then have elevated PSA levels – above 3ng/ml – they will be referred directly to their local hospital, rather than having to return to their GP for a referral for an MRI. “We’re improving the pathway so that these men are referred for early evaluation within two weeks,” says Dr. Ed Bosonnet, director of primary care for Medefer, a digital health care company involved in the project. The hope is to eventually provide men with urine 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 will then be able to log their readings on a website. Chiara de Biase, director of advocacy and advocacy at Prostate Cancer UK, said the charity was “very supportive of this initiative, which will help early detection by targeting those at the highest risk of prostate cancer. “Unfortunately, there are still thousands of men who have not been diagnosed since the beginning of the pandemic. This is the kind of initiative we’d like to support across the rest of the country to help find these men and catch more cancers earlier.”
5 of the best long-lasting salads
Long-lasting salads can be a better alternative to lunchtime sandwiches and chips. Here, Sophie Medlin from City Dietitians and president of the British Dietetic Association picks five of the best. Rio Mare Salad Beans and tuna 160g, £3.80, ocado.com Rio Mare Salad Beans and tuna Per 100g: Calories, 205; saturated fat, 1.7 g. protein, 11.5 g; vegetable 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 2.4 grams of salt in one serving — 40 percent of your daily limit. Serve with a small jacket potato for a more substantial meal. Taste: A bit bland. Napolina Five Bean Salad in Vinaigrette Dressing 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 box – kidney, black eye, borlotti, navy and lima – along with sweet corn, herbs and spices, 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: Nice, vinegary dressing. Jamie Oliver Mouthwatering Moroccan Salad Jamie Oliver Mouthwatering 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 pouch contains equal amounts of pre-cooked whole wheat, bran, and chickpeas. Oatmeal 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 salt content. Taste: Lemon with a mild taste of spices, a little oily. 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 gr This high protein, lower calorie salad has a good variety of vegetables. You’ll get 26 grams of protein from the salmon, as well as brain-healthy omega-3 fats. But there is an equivalent of three teaspoons of sugar. Taste: A little dry. Mediterranean quinola whole grain quinoa Mediterranean quinola whole grain 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…
