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

Array [File photo]

The UK’s first prostate cancer screening program is launching today in a bid to reduce 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 in a program which could be rolled out across the UK if it proves successful in detecting ‘hidden’ cancers in men with no symptoms. .

Men 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 usually only offered to men who show possible symptoms of prostate cancer (such as more frequent urination or blood in the urine) or those who have a strong family history of the disease.

The project, which is funded by NHS England to the tune of around £750,000, is run 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 be offered the opportunity to visit their local GP and have a PSA test.

Men 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]

Men 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 be given to those likely to be most at risk, such as people 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 has also been affected . In these groups, they will focus on men over 45 years old.

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

“We hope to save many 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 before it spreads to other parts of the body, treatment is not normally possible.

“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 just 60 or 70 percent of normal rates because men aren’t seeing their doctors.

“We have an obligation to do what we can to try to help men who may have cancer and not know it.”

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

If it is caught early and before it spreads outside 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 caught, after which the chance of surviving more than two years is slim.

Treatment for these men simply aims to slow the growth of the tumor with chemotherapy or by reducing the level 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 visit their local GP and have a PSA test [File photo]

All men aged 50 to 70 in the new scheme’s catchment area will be offered the opportunity to visit their local GP and have a PSA test [File photo]

One of the reasons thousands of men are diagnosed each year only when the disease has spread is that in the early stages, few have known symptoms – including more frequent urination, difficulty urinating, poor urine flow or blood in the urine, or sperm. .

Actor and comedian Stephen Fry has revealed that he had no symptoms at all when he was diagnosed with prostate cancer in 2017. He later said: “I was pretty knocked back – I had no symptoms to suggest anything was wrong. Fortunately, it was caught early, so it is better treated.”

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

As a result, the PSA test was not considered accurate enough to warrant its use in a national prostate screening program—like the test for breast and cervical cancer in women.

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

The fear was that if the national scheme went ahead, thousands of men with high PSA levels could end up having painful biopsies (where small samples of tissue are taken from the prostate to find a tumour) when they didn’t actually have cancer. all or had a tumor that grew so slowly that it was highly 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 becomes a problem.

These two types are often colloquially referred to as “tigers” and “kittens”.

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As part of the Surrey and Sussex pilot scheme, men with elevated PSA levels will undergo a biopsy only after they have also had an MRI scan (which generates detailed images of the prostate) to give crucial clues as to whether it is cancer, how big the cancer is. and whether it appears to be at risk of spreading.

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

“However, some large studies suggest that it is about as effective as breast cancer screening in terms of catching early cancers.”

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

“The men in our pilot project will only have a biopsy if warranted by MRI results – we hope to be able to distinguish not only that elevated PSA is caused by cancer, but to separate the tigers from the cats at an early stage and reduce the number 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 participating in the program will first be asked to provide a urine sample to rule out an infection that could cause falsely high PSA readings.

If they then have elevated PSA levels – above 3ng/ml – they will be sent straight to their local hospital, rather than having to return to their GP for an MRI referral.

“We are streamlining the pathway so that these men are referred for immediate assessment within two weeks,” says Dr. Ed Bosonnet, director of primary care for Medefer, a digital health company participating in the project.

The hope eventually is to provide men with both urine tests and PSA tests — using a finger-prick blood test similar to those used for diabetes — that they can do at home. The idea is that they could then log their data on a website.

Chiara de Biase, Director of Advocacy and Advocacy 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 been diagnosed since the start of the pandemic. This is the kind of initiative we would like to support in the rest of the country to help find these men and catch more cancers earlier.”

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The 5 best long-lasting salads

Long-lasting salads can be a better alternative to lunchtime sandwiches and crisps. Here, Sophie Medlin of City Dietitians and Chair of the British Dietetic Association picks out the top five.

Rio Mare Insalatissime beans and tuna

160g, £3.80, ocado.com

Rio Mare Insalatissime beans and tuna

Rio Mare Insalatissime beans and tuna

Per 100g: 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, it 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 get 2.4g of salt in a serving – 40 per cent of your daily limit. For a heartier meal, serve with a little mashed potatoes.

Taste: A bit bland.

Salad of five Napolina beans 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 can—kidney, black eye, borlotti, navy, and lima—along with 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's Mouthwatering Moroccan Salad

Jamie Oliver’s Mouthwatering Moroccan Salad

Jamie Oliver’s 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 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 salt content.

Taste: Lemon with a mild spicy flavor, 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 g

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

Taste: A bit dry.

Quinola Mediterranean whole grain Quinoa

Quinola Mediterranean whole grain Quinoa

Quinola Mediterranean 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 a great source of fiber.

Seasoned with tomatoes and olives, serve straight from the package.

Taste: Strong olive flavor.

Mandy Francis

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