Prostate cancer diagnoses: Concern for over 600 Scots men not treated

It is feared that men have not had the prostate check because of the Covid-19 pandemic lockdown and because only a limited number of patients have been able to go to GP surgeries where there are strict rules on physical distancing.

One in 10 men in Scotland are at risk from prostate cancer, more than 26,000 men are currently living with it and nearly 1000 a year die of it.

It accounts for 24.1% of all cancers diagnosed in men and before the pandemic around 300 positive cases were normally confirmed in Scotland every month.

Prostate Cancer UK has sounded the alarm bell over undiagnosed men as analysis of official data showed there were typically 35 fewer diagnoses every month in Scotland in the 18 months between April 2020 and September 2021 than there were over the same period before the pandemic.

It comes as Cancer Support Scotland has called for more action and funding to deal with a backlog in cancer diagnosis and treatment waiting times which it described as “a ticking time bomb” and a “national disgrace” which has been building even before the pandemic.

Prostate Cancer UK said men needed to find out more about their risk and what they can do about it saying their analysis shows over 600 Scots who need treatment have not yet come forward for a diagnosis because of the pandemic.

A 30-second online risk checker has been launched by the charity to find out more about whether they could have it and what they can do about it.

Nicola Tallett, acting chief executive at Prostate Cancer UK said: “Thousands of men are diagnosed with prostate cancer every year in Scotland, and we know that the earlier someone is diagnosed the better their outlook," she said.

“But since the pandemic men haven’t been having those vital conversations with GPs about prostate cancer.

"Most men with early prostate cancer don’t have any symptoms, so it’s important that they’re aware of their risk."

She said the Scottish Government was supporting their campaign to find the over 600 men who have prostate cancer but have not been diagnosed.

“We can’t afford to lose more ground because of the pandemic," she said.

The charity says prostate cancer is very treatable if caught early.

They believe the drop in diagnosis levels since the pandemic began is in part because men and GPs have had fewer discussions about cancer risk and the option of Prostate-Specific Antigen (PSA) blood tests.

The test, which can be done at a GP surgery, measures the level of PSA in your blood.

PSA is a protein made only by the prostate gland. Some of it leaks into the blood, but how much depends on your age and the health of your prostate.

But the PSA test sometimes misses prostate cancer. One in seven men with a normal PSA level may have prostate cancer, and one in 50 men with a normal level may have a fast-growing cancer.

However, experts say it can help find aggressive prostate cancers early – when treatments are more likely to cure the cancer.

While eight in ten men will survive prostate cancer thanks to chemotherapy and surgery, for a minority it can be difficult to treat because of how quickly it spreads to other parts of the body.

And four in ten are diagnosed at a later stage when treatment options are more limited.

Former BBC presenter Bill Turnbull revealed in March 2018 that he had been diagnosed with prostate cancer which had spread to another area of the body.

It comes as it emerged that a prostate cancer drug which was rejected by the NHS spending watchdog for England and Wales as too expensive could extend the lives of many more men than first thought.

The drug, olaparib, had been shown to be highly effective in treating a specific genetic type of the disease, but it is now thought the tablets could work for a much wider group of patients.

This means it could be used to help thousands of cancer victims each year in the UK, rather than just a few hundred.

Although olaparib has been given the green light for prostate cancer patients by the Scottish Medicines Consortium, the National Institute for Health and Care Excellence (NICE), which has to approve NHS drugs in England and Wales, last month deemed the drug too expensive.

It said existing evidence wasn't strong enough to justify the annual £37,000 per patient cost.

But experts hope new data, which was to be presented this week at the American Society of Clinical Oncology Genitourinary Cancers Symposium, will help to change its decision.

Archibald Muir, 68, was one of the first in the UK to receive olaparib on the NHS in Scotland.

The butcher from Glasgow found out six months ago that his prostate cancer, which developed three years ago, had returned and spread to the bones in his back.

Doctors started Mr Muir on the medication after his relapse, and within a month he was out of hospital.

According to the cancer charity, prostate cancer mainly affects men over 50, and the risk continues to increase as you get older.

It is suggested that those who may be at risk should speak to a GP who can offer phone and video appointments, if getting to a surgery is unsuitable.

Early prostate cancer does not normally have any signs, so it is suggested that people should not wait for symptoms to talk to a GP about the risk of prostate cancer.

In December NHS Scotland again failed to meet a key waiting times standard for treating cancer patients with fewer people starting to get help within two months of their initial referral.

Ministers have set the target of having 95% of patients begin treatment within 62 days of being referred for help because cancer is suspected.

However, between July and September 2021, only 83.1% began their treatment within the timeframe - down from 84.1% in the previous three months and below the 87.3% that was achieved in July to September 2020.

None of Scotland’s 14 health boards met the goal of starting patient’s treatment within two months of referral for any cancer types.

Official data showed that 4,000 fewer people had received cancer diagnoses when the cancer screening and detection tests were on hold from April to June in 2020.

The Scottish Government said Omicron has added to pressures on the NHS leading to health boards having to make tough decisions.

It said cancer is a priority and one of its targets, the 31-day waiting time, has been consistently met.

Health secretary Humza Yousaf said: “The earlier prostate cancer is found, the better the chance of a good outcome. Information is paramount to find the “missing men” who may not be aware they have it.

“Throughout the COVID-19 pandemic, cancer has remained our priority and we are focused on ensuring patients are diagnosed and treated as quickly as possible. Any men who have concerns or who notice any physical changes should contact their GP practice.”