I am relieved to hear that David Cameron caught his prostate cancer early enough to receive successful treatment, and that his wife Samantha pushed him to get checked after hearing me banging on about early screening on the radio.
It was Samantha who persuaded her husband to ask his doctor for the simple prostate specific antigen (PSA) blood test, which first raised the alarm.
After an MRI scan and biopsy confirmed the diagnosis, David underwent a minimally invasive new treatment, focal therapy, which uses needles delivering electric pulses to destroy cancerous cells. He is now cancer-free.
And this is the point: whether a man gets screened for prostate cancer shouldn’t depend on overhearing a radio discussion or a former Prime Minister going public. Screening should be automatic once men reach a certain age.
I care deeply about prostate cancer screening because my life, too, was saved after tests found a large, aggressive tumour in my prostate in 2022.
The fact that it was discovered at all was pure luck: I had no symptoms and felt perfectly healthy. My PSA test was given routinely as part of my private healthcare, but the majority of men rely solely on the NHS.
Ever since my diagnosis and treatment, I’ve tried to allay men’s fears – including of impotence and incontinence, both side effects associated with old-fashioned prostate surgery.
Thanks to modern techniques, any problems I experienced were short-lived. But even if I had suffered longer-term issues I would still rather be alive.
Samantha Cameron persuaded her husband, David, to get tested after hearing Nick Jones (pictured with Sam) banging on about early screening on the radio
That is why I have been campaigning with the charity Prostate Cancer Research for screening, and why earlier this year I lent my name to the Daily Mail’s vital campaign for a nationwide prostate cancer-screening programme.
It is why I hope the UK’s National Screening Committee (UK NSC) will this week decide to introduce screening that could revolutionise early detection and save thousands of lives.
More than 63,000 men are diagnosed with prostate cancer every year and more than 1,000 die of it every month. It is the second-biggest cancer killer after lung carcinoma, which itself is expected to become less common thanks to a newly introduced national screening programme.
The awful truth is that almost no man need die of prostate cancer. If caught early, survival is close to 100 per cent.
But undetected, it can spread to the bones and other organs. If it gets to that stage, less than half of men are alive after five years, and fewer than one in five survive a decade.
The last time the UK NSC examined screening, in 2020, it decided against it partly because the PSA test can produce false positives and negatives, leading to overdiagnosis, overtreatment and unnecessary anxiety.
Of course it is stressful to hear you have raised PSA levels.
Women also find cervical smears and mammograms stressful – but they cope with a degree of worry because they know that, overall, screening saves lives.
Those checks are now so routine that women talk openly about them, share experiences and support one another. Men would do the same if prostate checks became a routine part of their lives.
In any case, the idea that screening inevitably causes widespread overdiagnosis and overtreatment is simply out of date. The way we diagnose and treat prostate cancer has changed dramatically. It is far more accurate and far safer than it was just five years ago.
And the benefits of spotting prostate cancer early, when there are no symptoms, far outweigh the stress experienced by those who are ultimately given the all-clear.
Crucially, there have been significant medical advances since the UK NSC last reviewed the evidence. A raised PSA no longer necessarily leads to an invasive biopsy. The next step these days is an MRI scan.
Most scans will be negative. But if a tumour is visible, the MRI pinpoints its exact location, allowing a precise, targeted biopsy through the perineum – a far more accurate and safe approach than the old technique that involved going through the bowel wall.
If cancer is confirmed, the range of treatments is now far wider and with fewer side effects.
Because prostate tumours typically grow slowly, if caught early many men may be best managed with regular monitoring rather than immediate treatment. And if the cancer does start to grow, that regular monitoring ensures it is caught early enough to be treated before it spreads.
Quite apart from explaining how he came to get tested, David Cameron also spoke about the pioneering focal therapy he underwent.
Radiotherapy and other modern treatments are also improving rapidly. A radical prostatectomy, or total removal of the prostate gland, was once the default option but is now far from the only course of action. And even if a prostatectomy is required, that is now performed robotically.
Some worry about the cost of testing on a large scale. But modelling by Prostate Cancer Research and Deloitte has shown that there is a positive socioeconomic benefit if we start screening high-risk men now.
Moreover, early interventions are far less expensive – and far less traumatic – than treating thousands of men whose cancer has been allowed to reach Stage 4. Screening would not only save thousands of lives, it would be good for the economy.
The UK NSC is meeting on Thursday to decide whether it will recommend prostate cancer screening. If they do – and I hope with every fibre of my being they will – I suspect they will recommend targeted screening starting with men at highest risk, such as those with certain genetic markers, men of black ethnicity and men with a family history of prostate, breast or ovarian cancer.
It would be a great first step on our way to a screening programme for all men aged 50 and above – and it would save countless lives.
Ultimately, the decision on whether to go ahead with the programme rests with Health Secretary Wes Streeting, and I urge him to act.
Too many men are dying needlessly while we leave the detection of this cancer to chance.
The true cost of prostate cancer is not only the years of painful, expensive treatment for men diagnosed too late. Nor is it only the 12,000 deaths each year. It is the devastation left behind – the wives, partners, children, grandchildren, friends and families who watch a slow, preventable decline and live with an irreplaceable loss. Worse still, they know it didn’t have to be this way.
The only way to make sure it is caught early is to introduce a nationwide screening programme. It really is that simple.
- Nick Jones is an entrepreneur and founder of Soho House.
