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Every once in a while you read a great article that stirs you to your core. I would like to praise Angela Epstein who interviewed Professor Roger Kirby, Director of The Prostate Centre in London, for her fantastic interview with Professor Kirby in the Good Health section of the Daily Mail on Tuesday 26 August. Professor Kirby was very candid in his interview entitled, “Why all men over 50 must demand a prostate test – it helped save my life”. He describes his diagnosis with cancer about a year ago. Because of his specialist knowledge he was able to act quickly when he suspected the disease and because he had the best tools at his disposal he was able to give himself the best chance at beating it.

But most men aren’t so lucky. Epstein states that unfortunately most of the 40,000 men diagnosed with prostate cancer in Britain each year cannot bank on such in-depth expertise. There is more of an arbitrary approach to the diagnosis, which is usually driven by symptoms such as rushing to the bathroom or a conscientious GP who does a check-up of the prostate and provides PSA (prostate specific antigen) test.

It always puzzled me that there is no National screening programme for prostate cancer; with my public health hat on I feel there should be, many other doctors would believe that as well. But a European randomised study of screening for prostate cancer involving 162,000 men aged between 50 and 74 concluded that, whilst screening could save around 2,300 lives in Britain annually, 2 out of 5 men who were told they had cancer would be over-diagnosed (i.e. they will be diagnosed even thought the disease would never cause symptoms or death in the patient). Epstein suggests that this could lead to unnecessary investigations such as biopsies, radiotherapy or even surgery. However, the article then states that over-diagnosis could be ruled out if every man over 50 were to ask for an annual PSA test. Anyone with the raised level could then have an MRI scan performed to identify the presence or extent of cancer. Epstein correctly deduces that that doing this could eradicate the scattergun approach with biopsies that could cause side effects and intense anguish.

I was very happy to hear of Professor Kirby’s own personal experience, but as is stated at the very beginning; knowledge is power. Finally, the article goes on to state that since 10,000 men are dying of prostate cancer every year, his advice would be that men over 50, especially those with a risk factor such as family history, should have a PSA test. And don’t be distracted by a GP who says results are unreliable.

I would like to congratulate Professor Kirby as this prompted me also to rethink my ideas and made me also aware of the necessity and the value of having this test performed.

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