I was diagnosed with prostate cancer – this is what all men need to know

The telephone call, when it came, was as unexpected as it was unsettling. I had gone to my local GP surgery the previous day for a routine five-year health check and now my doctor wanted to know if I could pop back in to discuss the results. Sure, I said, when can you fit me in? This afternoon, if it’s convenient, came the reply.

With a sense of foreboding, I arrived at the surgery to be told that, whilst all my other markers were in range, my prostate-specific antigen (PSA) score was sky high. Anything above five is a red flag and indicates you may have cancer. Mine was 21.7. I trudged home and broke the disturbing news to my wife, Fiona, but told no one else, not even my son and our two daughters.

That was in early March 2022. Two weeks later, my body was sliding into an MRI machine at the Princess Royal Hospital in Haywards Heath and a month after that I, was back at the same hospital having a biopsy, which revealed my Gleason score to be 4+3 – meaning that I had a relatively aggressive and fast-developing prostate cancer.

The good news, said the urologist in the sunny, matter-of-fact manner in which doctors seem to specialise, was that the cancer was contained within the prostate, which meant that it was both treatable and curable. I was put immediately on hormone therapy to block my body’s production of testosterone and halt further growth of the cancer. By now, it was June.

Armed with this information, I finally delivered the news to my two tearful and understandably upset daughters and my more phlegmatic son. I also told my older sister and two younger brothers – and suggested they both had their PSA levels checked immediately.

But that was as wide as the circle of knowledge went. Why should I bother anyone else with my medical condition? It was no one else’s business but mine. And like David Cameron, who has just publicly disclosed that he has also been treated for prostate cancer, I didn’t fancy sharing my intimate personal health issues with the whole world. It would be self-indulgent, a touch self-pitying even, in a mawkish and prurient sort of way.

Meanwhile, the NHS juggernaut rolled on. My oncologist ordered a bone scan to double-check the cancer had not spread – metastasised, in the medical parlance – and I was scheduled in for surgery in late August to remove my prostate.

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I was never given the results of the bone scan and so arrived on the appointed day at Eastbourne Hospital to have my pesky prostate excised. I was directed to the ward and got dressed in my surgical gown ready to be taken to theatre. It was then that the medical team informed me they had just seen the results of my bone scan and, unfortunately, it showed a cancer spot on one of my vertebrae. The cancer had indeed metastasised, meaning that to carry out a prostatectomy would be pointless or, to use the precise words of my surgeon, “criminal”. I was discharged from hospital, dazed and confused and with what effectively amounted to a slow death sentence. I was 65 and could expect to last another three, maybe four years.

My oncologist called me at home the following day (I remember it was a Saturday) to apologise profusely for failing to pick up on the results of the bone scan and to tell me he was ordering a more detailed PET scan and spinal MRI the following week. Time then stood still for a fortnight or so and our house became a home of long, gloomy silences and not a few tears.

I recall hearing the renowned author and brain surgeon Henry Marsh talking on the radio about his prostate cancer and commenting in passing that when the cancer spread to the spine it invariably resulted in paralysis. That did not improve the mood. And then, sometime in early September, my oncologist called me again with some rather different and better news: the bone scan had been an anomaly. He could not explain why but my PET scan and MRI were clear. It meant there was no metastasis. My cancer was curable again, not terminal.

It was at this point that the dam broke. My poor darling Fiona had been struggling especially with the burden of keeping my condition a secret from everyone but immediate family (oddly, it is your nearest and dearest who suffer the distress and pain most severely). And so I told my book group and my biking group and my tennis and footballing pals about it. And then I wrote a long email to all my other friends describing what we had been through as a family for the past seven months, urging all of those who were male to have their PSA tested post haste.

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It proved a tremendous catharsis for the whole family. And I know it has increased the queues at many GP surgeries around the country. One friend has just had treatment, another is about to undergo it. The pioneering examples of David Cameron, Nick Jones and especially the remarkable, redoubtable Sir Chris Hoy can only lengthen those queues even further.

In the event, I did not proceed to surgery but opted, on the advice of the multi-disciplinary team at the Princess Royal, to have a month-long course of external radiotherapy followed by a more invasive procedure called brachytherapy, whereby the prostate is bombarded directly with a high dose of radiation to attack the cancer. Surgery and radiotherapy are equally effective. I would guess that most men would prefer to just have the damn thing cut out, but surgery carries with it the risk of impotence and incontinence. After that came a further 18 months of hormone treatment.

I now have my PSA tested twice a year and it remains reassuringly negligible. And my testosterone levels are looking more perky. My oncologist tells me that because I have had the disease, my PSA level is now a very good marker of the condition of my prostate.

Unfortunately, the same does not apply more generally. The PSA test is not a terribly reliable indicator because it can easily produce false negative and false positive results. An MRI is much more accurate but also much more expensive. Despite this – and until a better, simpler and more reliable means of screening for prostate cancer is devised – I have become a proselytiser for prostate awareness. Gentlemen: if you have prostate cancer, don’t keep it to yourself. And make your mantra: test, test, test.