We’ve battled prostate cancer like Eastenders’ Alfie Moon – here’s what all men must know
EASTENDERS character Alfie Moon will be given a prostate cancer diagnosis in the coming weeks.
It is the same devastating news that more than 52,500 men in the UK receive every year.
One in eight men will be told they have prostate cancer in their lifetime, making it the most common cancer for British blokes.
Viewers have already seen Alfie, played for 20 years by Londoner Shane Richie, 59, being told by his doctor that “it’s not good news” and early results “indicate a high chance of prostate cancer”.
Alfie knows he needs to undergo prostate cancer tests and producers say he is set to face a “tough road ahead”.
Emma Craske, senior specialist nurse at Prostate Cancer UK, tells Sun Health: “We hope that storylines like these will open up conversations about prostate cancer.
“It’s brave when celebrities come out and say that they’ve been diagnosed with prostate cancer.”
Last week Duran Duran’s Andy Taylor revealed he now has no cancer symptoms after being told he needed “end-of-life care” following a stage 4 diagnosis in 2018, while celebrities including Ian McKellen, Stephen Fry, and Ben Stiller have shared their experiences.
And last week, the “extremely exciting” results of a new study gave fresh hope that a screening programme could one day be rolled out.
University College London showed that a ten-minute MRI scan was far more accurate than the PSA test which is currently the first test GPs use.
Emma says: “Early prostate cancer is potentially very curable, but it doesn’t usually cause any symptoms.
“We would encourage men to be proactive and understand their risks. Don’t wait for symptoms.”
Time to get clued up . . .
‘My PSA was so high, I cried for my sons’
PATRICK WILLIAMS, 67, a grandad from London, knew that as a black man, he was more at risk of prostate cancer.
But the retired dance lecturer and performer, says: “I really didn’t want to know, I had no symptoms and some [of the tests] are intrusive.”
When Patrick eventually had a PSA test in October 2019, the result was extremely high.
Each test added more concern.
Patrick said he “lit up like a Christmas tree” during a PET scan, which highlights areas of cancer in the body. He called the Prostate Cancer UK support line when it was confirmed he had aggressive, incurable cancer.
“After that phone call, I cried like a baby for over an hour,” he recalls.
“I was crying for my four sons, and the 12 grandsons they have given me. I had passed on a killer. Then the Covid pandemic hit. A double whammy! I was on my own.”
Patrick was put on a clinical trial that combined hormone therapy, which halts testosterone production, and therefore the cancer’s growth, and chemotherapy.
The treatment brought his PSA levels right down and now he has hormone injections every three months.
During treatment, Patrick found himself in severe financial difficulty, and was evicted from his home.
He spent three nights on the street before the council stepped in.
“I am as comfortable and as stable as I can be, given the circumstances,” says Patrick of his health now.
“It’s not a place that I would want to be, with this hanging over my head.
“But you’ve got to be positive and believe that you will overcome this.”
‘My life was saved but my libido was destroyed’
ENGINEER Andy Phillips of Eagle, Lincs, was a fit and healthy man when he was diagnosed in 2013, at the age of 48.
His wife Carol, 57, a retired nurse, encouraged him to tell the GP about his frequent peeing in 2016.
Andy, now 59, says: “I recognised that I’d pee a couple of times on the dog walk. I just thought it was part of getting old.”
The couple, who have been together for 38 years, were shocked to be told Andy had advanced cancer with limited treatment options.
It had spread to the bone and become incurable.
Andy says: “We came out of the appointment and we both just cried. We thought I’d be dead by the end of the year.”
Andy had various forms of treatment, including having his prostate and the nerves around it removed just after diagnosis.
But in order to save his life, treatment meant he would no longer have any sexual function.
“That changed so much in our relationship,” says Andy.
His quality of life, he says, is more important to him than participating in experimental drug trials.
The impact on his mental health was the most surprising part of the past decade.
Andy says: “I thought mentally I could deal with this and I couldn’t.
“It was really, really strange.”
Know your risk
TO catch prostate cancer early, it’s important to know your risk.
Visit prostatecanceruk.org/risk-checker to take the quiz to check your risk in 30 seconds.
You are two and a half times more likely to get prostate cancer if your father or brother has had it, and one in four black men will receive a diagnosis.
Prostate cancer risk increases with age, but men under 50 are not immune.
Emma says: “We would recommend black men and men who have a family history to talk to their GP about being tested from the age of 45.
“Men over 50 can also have a PSA blood test.”
The symptoms
PROSTATE cancer doesn’t always show symptoms in the early stages, but if the cancer grows large enough, it can put pressure on the urethra – the tube your body releases urine from.
Men may pee more often and urgently, they can have difficulty starting to pee or a weak flow.
Emma warns to not put this down to ageing. She says: “If men have any new urinary symptoms, we would always suggest they have a chat with a GP.”
If the disease spreads, common symptoms include back, hip or pelvis pain, which Emma says men can mistake for usual aches and pains.
Erection problems and unexplained weight loss may also occur.
Emma adds: “Unfortunately, too many men aren’t diagnosed until they’ve got symptoms, when the cancer has spread elsewhere.”
The PSA test
WHEN it comes to the actual test, don’t fret.
Emma says: “A lot of men think the first investigation would be the digital rectal examination, or the ‘finger-up-the bum’, as it used to be.
“These days, the first test a GP is likely to do is a PSA blood test.”
A PSA blood test measures your level of prostate specific antigen, a protein produced by prostate cancer cells.
However, “any prostate problem can cause a rise in PSA,” says Emma, including an infection, enlarged prostate – which tends to happen as men get older – vigorous exercise or recent ejaculation.
Emma explains: “About 75 per cent of men with a raised PSA have not been found to have prostate cancer.
“It’s not a terribly accurate test, but it’s the best first test that GPs have got.”
Raised PSA levels may lead to an MRI scan, and if there are high-risk abnormalities, medical professionals will proceed with a biopsy.
These tests can cause unnecessary stress if it turns out there is no cancer present.
Emma adds: “Because the PSA blood test isn’t perfect, men do need to have a conversation about the advantages and drawbacks of having that test before they have it done.”
Treatment road
ONCE diagnosed, doctors decide treatment based on a number of factors.
Emma says: “Most men are diagnosed with prostate cancer that’s contained in the prostate or just outside the prostate, when the aim of treatments is to cure.”
If the cancer is contained in the prostate, removal of the gland during a surgery called radical prostatectomy can eliminate the cancer entirely.
But there are some potential side effects, because the prostate sits close to nerves that control erections and the bladder.
Emma says: “Men can experience erectile dysfunction and incontinence.”
These side effects can improve over time, but some men may need medical intervention.
For those not fit enough for the op, hormone therapy and external beam radiotherapy is very common and can be just as effective.
“With advanced disease, where it’s spread to the bone, for example, then you’re looking at systemic treatments that can go all over the body, such as long-term hormone therapy, which can make people feel quite tired, affect sex drive and muscle mass.”
Emma says men can live many years with advanced prostate cancer, thanks to improving treatments.
What it looks like
IT’S important to note that prostate cancer is “particularly complex”.
Emma says: “There’s something odd about the way that prostate cancer behaves.
“Some prostate cancers don’t actually need immediate treatment because they are felt to be a low risk type.
“Men can have something called active surveillance, which has been shown to be safe in clinical trials, and if the nature of the cancer changes, then they can be offered treatment.”
Active surveillance is when doctors regularly do tests to check if the disease is growing.
Because prostate cancer grows slowly, it may not cause symptoms for years or even a lifetime.
Emma says: “One of the advantages of being on active surveillance is that you postpone treatment, and some men actually will never need treatment in their lifetime.
“There are some men even with advanced disease who say, ‘Well, my quality of life is really good. Actually, I don’t want to be treated at the moment’.”
Men with low-risk localised prostate cancer who go on active surveillance, have surgery or radiotherapy all have the same chances of living for ten years or more, according to medical research.
Emma adds: “It would be lovely to have a crystal ball because these are really tough decisions for men.”