Professor Dasgupta's article from The Times

Sir Chris Hoy’s bravery in talking about his prostate cancer is to be applauded, and there are lessons be to learnt from his experience.

For men with clear family histories of prostate cancer, the advice should be to have prostate specific antigen (PSA) blood tests from the age of 40 – though the UK, like most other nations, does not at present have a screening programme for prostate cancer. The focus should be on informed decision-making and “smart screening” to help men with strong family histories. This may mean a family history of other cancers, such as breast cancer, as prostate and breast cancers sometimes share mutations in genes such as BRCA.

The blood test on its own is often inaccurate as PSA can be raised by other conditions, such as a urine infection or benign enlargement of the prostate. In most men with raised PSA, in the absence of a urine infection, the next step is an MRI scan and, if abnormal areas are found, possibly a biopsy. Other scans are being investigated to increase the accuracy of MRI, and new blood tests may prove to be far more accurate than the PSA test alone.

Although there are concerns about overdiagnosis, it would be better to diagnose the cancer while it is within the prostate than after it has escaped. Cancers that do not need treatment can be monitored safely for years.

I hope Hoy’s story will bring more awareness of prostate cancer among men with strong family histories.

Professor Prokar Dasgupta

King’s College London