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Men over 40 who enjoy sex should be more worried about prostate cancer

When I was 45, I became depressed. The doctor prescribed this panacea that is called Prozac. It worked. Powerless in the mid-50s, she prescribed Viagra. That also worked.

When my knees started to move, the electric bike became more affordable. I rode at the top of a pharmaceutical and technological wave.

But when I was 56, the weapon broke over me and I had a failure.

It was on a Sunday morning in 2013 after a party. I woke up early with a hangover and a full bladder, went to the bathroom and couldn’t go. Half an hour later I tried again and it barely worked.

A few days later I saw my doctor about something else and mentioned my recent difficulty. She arranged that I would take a blood test and, a week later, announced that the test had shown that I had a prostate-specific antigen (PSA) score of 55.

Life for the day: Jeremy (left) and his brother Jim (right). Jeremy Clarke already had the cancer. But a doctor told his 46-year-old brother that he didn't need to be checked. Now they are both fighting to survive

Life for the day: Jeremy (left) and his brother Jim (right). Jeremy Clarke already had the cancer. But a doctor told his 46-year-old brother that he didn’t need to be checked. Now they are both fighting to survive

A PSA score between zero and three is normal. A score of 55 meant that I had prostate cancer, no buts.

The only question in the doctor’s mind was how far the cancer had spread from my prostate to the rest of my body.

This was the first time I heard the dreaded three letter acronym PSA, which would appear so urgent and ominous in what was left of my docked life.

I remember looking at her the way Freddie Starr imitated a startled deer. If the cancer were limited to the prostate gland, I could have a robot carve it out and go home sexually impotent but cancer free.

This was the best I could hope for. The party may be over. I would no longer be a player. But I could live a different normal life, collect stamps, and die from something else.

A few days later, a urologist with a strong mustache put his finger on my buttocks and felt around. Then he cut a bit of my prostate gland (ow!) And sent it away for analysis.

Then I went down the hall and up a set of stairs and lay down on a tray that moved me back and forth under an X-ray scanner. I waited five weeks to know the results.

Five weeks is in death row. The novelist Anthony Powell once claimed that the essential ingredient of every best-selling novel is self-pity. In those five weeks I should have written one and retired.

Baroness Trumpington and Jeremy Clarke take part in The Spectator Cigar Awards Dinner in 2014 in London

Baroness Trumpington and Jeremy Clarke take part in The Spectator Cigar Awards Dinner in 2014 in London

Baroness Trumpington and Jeremy Clarke take part in The Spectator Cigar Awards Dinner in 2014 in London

Cancer was the first thing I thought of every morning. Even when I laughed, I thought about dying. Something came from the sound of a clock that struck the hour. A beautiful view the same. My hair turned gray.

Finally a letter came from the hospital. It was an appointment to see an oncologist and to hear the biopsy and scan results. I was led into a small room with no window with a door on both sides.

This was my introduction to the Elizabethan drama of the oncologist’s consulting room – always a door that opened and someone who brought serious news.

Today the door I least expected opened and a distinguished, ethereal woman slipped inside. She pulled up a chair and looked into my eyes as she spoke to show that she was hiding nothing.

The cancer was very aggressive. It had spread to my stomach lymph nodes. A lymph node near my heart was suspiciously enlarged. However, the cancer was not yet in my bones.

This was a big plus. And she had a lot of “weapons” in her treatment “arsenal,” she said.

What we were going to do, she said, was throw the sink at the cancer and see how it went.

I found this NHS oncologist nice and familiar. And golly, she knew her onions.

When it was my turn, I asked the inevitable question: “How long?”

“Oh, probably years,” she said.

I left her consulting room with a powerful ally and the enemy in full view. And it was a great relief to know that I was more than just a few clean shirts away from a Co-op funeral.

Prostate cancer feeds on testosterone. The sink turned out to be monthly injections that stopped my testosterone production. Then there was six weeks of daily radiotherapy, the rays focused on my prostate and lymph nodes.

Then a procedure called brachytherapy, in which radioactive needles were introduced directly into my prostate.

I was also enrolled in a clinical trial of the expensive (£ 2,000 per month) new abiraterone drug, which cleans up the small amount of testosterone produced in the adrenal glands.

Without testosterone I changed physically and mentally. I grew breasts, became more empathetic and enjoyed Nick Drake’s music. With my adrenals out of action, nothing scared me.

Prostate cancer is now the most diagnosed cancer. It used to be lung cancer. In 1996 the lung was overtaken by breast cancer. This year, prostate breast cancer advanced in this horrible statistical Grand Prix.

The above story, or something like that, can be told by one of the 330,000 living British. About 1,200 of us will die from our cancer in 2020.

When my cancer was diagnosed in 2013, I was 56. My brother, Jim, a big, perishable policeman, was 46. Afraid that we could share the same defective gene, he asked his doctor for a PSA test. They told him that he was young and did not have to worry about his pretty little head.

Then in 2016, he couldn’t pee either. His doctor admitted a blood test.

His PSA score was 120. Prostate cancer had already spread through his lymph nodes to his hip bone. It was too late for radiotherapy and he went straight to the hardships of chemotherapy.

So for me and my brother, the present is no longer a temporary thing; it’s everything. We look at passers-by surprised at their unconsciousness of their own mortality.

We compare our new breasts as a pair of 13-year-old girls. We try to carry our feelings of despair lightly and to avoid the narcissism of sentimentality. We usually succeed.

Because another technological wave is gathering among us and carrying us up. Radiation therapy is more accurate and effective than ever before.

New drugs such as abiraterone, bicalutamide and enzalutamide, plus a new immunotherapy treatment, mean that 84 percent of us are still ten years after diagnosis.

And the new improved penis vacuum pump (in combination with a tolerant partner – “Hold on, love …”) means that sex is no longer completely excluded.

But prostate cancer has been the Cinderella cancer for far too long. Yes, the old PSA blood test is controversial and inaccurate. A new, simpler and more accurate test must be devised and widely advertised, ideally as a national screening program.

Men over 40 who love sex and want to live in their 70s should be more worried about prostate cancer.

And chaps – it’s 2020. Stoicism is passé. Worrying about your health is absolutely fine.

BAD, GOOD, BEST: How to get the most out of food choices

This week: Apple

BAD: Apple sales

With a typical recipe, even a small turnover (about 80 g) contains 1½ to 2 teaspoons of added sugar.

And with the sweetened apple enclosed in pastries, you also get around 250 calories and 6.4 g of saturated fat (almost a third of the recommended daily intake), which can increase blood cholesterol.

GOOD: Baked apple

A large baked apple provides around 10 percent of your daily recommended intake of bowel-friendly fiber and counts as one of your five-a-day.

Filling the stuffed apple with two tablespoons of raisins makes it two of your five a day and 13 percent of the recommended daily fiber intake. However, do not add too much honey or brown sugar.

BEST: Stewed apple with blackberry

This is a great combination – apples are a good source of quercetin and blackberries contain a lot of catechin, two antioxidants that work together to prevent platelets from clumping together, which in turn can help reduce the formation of clots in blood vessels.

A portion of 80 g of each fruit counts as two of your five-a-day.