Over the course of a week I read a lot of scientific papers (so you don’t have to) and one of the things I always pay close attention to is everything about prostate cancer.
It is the most common cancer in British men and over the past decade deaths from other common cancers such as colon and breast cancer have fallen, while deaths from prostate cancer have risen.
I have a particular interest in prostate cancer because my father was diagnosed when he was in his sixties (about the same age I am now).
I am well aware that because my father had prostate cancer, my chances of getting it are about two and a half times higher than if he hadn’t.
So you might think I’m very much in favor of prostate cancer screening, but if my father’s experience has taught me anything, it’s that this particular issue is much more complex than you might think.
It is the most common cancer in British men and over the past decade deaths from other common cancers such as colon and breast cancer have fallen and deaths from prostate cancer have risen.
The prostate is a gland, about the size of a walnut, that surrounds the urethra — the tube you urinate through. Unfortunately, it grows from our 50s and men often experience symptoms caused by the prostate compressing the urethra, such as waking up frequently at night and having trouble starting to urinate.
While these can also be symptoms of prostate cancer, they are normally the result of an enlarged prostate.
One of the scary things about prostate cancer is that there are rarely any symptoms until the tumor has grown quite large or has spread.
And once that happens, you may experience back pain, trouble getting or maintaining an erection, blood in the urine, or unexplained weight loss.
Your chances of developing prostate cancer increase after age 50 and it is more common in men of African-Caribbean or African descent. As I mentioned, your risk is two and a half times greater if your brother or father had it, and there is research that suggests that being significantly overweight also increases your risk.
Which brings us back to screening.
Many famous people have had prostate cancer, including Noel Edmonds and Robert De Niro. Most of these famous names only found out they had cancer by taking a PSA test — a blood test that measures prostate-specific antigen, a protein whose levels increase when cancer is present.
A few years ago, author and broadcaster Stephen Fry described on Twitter that he was diagnosed with prostate cancer after a routine health check revealed he had high PSA levels. It turns out they caught him just in time, because he was, in Stephen’s words, “an aggressive little bastard.”
A few years ago, author and broadcaster Stephen Fry described on Twitter that he was diagnosed with prostate cancer after a routine health check revealed he had high PSA levels. It turns out they found it just in time because it was, in Stephen’s words, “an aggressive little bastard”
Examples like his seem to advocate routine PSA testing, but it’s not that simple.
PSA levels can rise not only from cancer, but also from infection or everyday inflammation.
When I was in medical school, I was told that PSA stands for “promoting stress and anxiety,” and that routine PSA testing can do more harm than good. That message was reinforced a few years ago when I put myself through a series of health tests for a film for BBC Horizon to see which ones were worth doing.
These include having my blood pressure measured, a PSA test, and bowel scope screening (which may require the use of a tube up your butt).
I concluded that having my blood pressure and gut checked was a good idea, but the benefits of the PSA were less clear.
Not only does it produce many false positives, but it also warns you of the presence of cancers that may never affect your life; 70 percent of men over 80 have prostate cancer, but most will die of something else. My father is a good example.
He had a PSA test, as part of a private health check, and further testing revealed he had prostate cancer. He underwent invasive surgery to get rid of it, but the impact of the surgery devastated the last years of his life.
It’s possible that the treatment slowed the disease, but it’s also possible that it was a slow-growing tumor and he would have died without knowing he had it. In fact, he died of unrelated heart failure several years after surgery.
The good news is that more and more tests are becoming available that can distinguish fast-growing cancers from benign forms. These include a ‘multi-parametric magnetic resonance imaging’ (mpMRI) scan, which creates more detailed images of the prostate than a standard MRI scan.
These are available on the NHS and recent studies have shown that they are significantly better at identifying dangerous prostate cancers than biopsies (which require inserting needles into your prostate to see if it contains cancer cells).
Since biopsies and overtreatment – treating cancer that will never prove difficult – often lead to impotence and urinary incontinence, I will book myself an mpMRI if needed.
The other good news is that treatments have improved since my father’s surgery 30 years ago.
There are now plenty of other options, including cryotherapy (freezing the cancer cells) and high-intensity focused ultrasound — using ultrasound to heat the tumor to try to kill it.
If you have any symptoms or are just concerned, talk to your doctor.
Why it pays to work on an egg
I ran out the door every morning after a quick breakfast of toast or cereal. These days I have a more filling, protein-rich breakfast, such as scrambled eggs or kippers.
That’s because I know it will make me feel full for longer so I won’t feel hungry at 11am. Another good reason is that a high-protein breakfast can help build muscle.
In one study, researchers in Japan gave 60 middle-aged women a food questionnaire and then tested their grip strength.
The women who ate more protein at breakfast did better on the grip strength tests.
Animal studies have shown that even if they don’t consume more protein, protein consumed earlier in the day leads to bigger muscles.
A good excuse for a hearty breakfast.
Tricks to avoid forgetting people’s names
As we get older, most of us struggle with our memory, especially when it comes to putting names on faces. But there are some notable individuals called “superagers” whose brains seem to be impervious to the passage of time.
Scientists at Harvard Medical School recently discovered the secret to their success. To do this, they asked 40 superagers, with an average age of 67, to participate in a memory test while inside a functional magnetic resonance imaging (fMRI) scanner, which measures brain activity, and had 25-year-olds do the same.
The researchers were interested in studying the visual cortex, the part of our brain that processes what we see. It has several clumps of brain cells whose job is to identify only faces, animals or objects. As we age, the ability to identify certain things, called neural differentiation, declines. We struggle to make connections, to put names on faces.
But in this experiment, superagers were just as good as the 25-year-olds in the memory tests, at least in part because their brains maintained the same high level of neural differentiation as the youngsters. What is not known is whether this is an innate ability or the result of some form of brain training.
I have trouble remembering names, so I create mental images to tag people with. When I meet someone named ‘Ben’, I imagine a huge clock (Big Ben) on his forehead to help me remember his name.
The Harvard team has started a trial to see if a course of electromagnetic stimulation (which delivers a small electric shock to parts of the brain) can improve memory in older adults. I like to think I don’t need it, but you never know.