Men face 'postcode lottery' for prostate cancer diagnosis, charity warns

The proportion of patients diagnosed with the disease when it is too advanced to treat varies significantly depending on where patients live, Prostate Cancer UK said. Credit: PA

Patients with prostate cancer across the UK are facing a “postcode lottery” for care, a charity has warned.

The proportion of patients diagnosed with the disease when it is too advanced to treat varies significantly depending on where patients live, Prostate Cancer UK said.

Chief executive at Prostate Cancer UK, Laura Kerby said: “This postcode lottery for cancer diagnosis simply isn’t fair, and the picture in Scotland is particularly shocking."

In Scotland, more than a third (35%) of men are only diagnosed when the disease is classed as stage 4, also known as metastatic cancer – which means the cancer has spread to another part of the body.

This is compared to just 12.5% of men in London.

Almost 10,000 men across the UK are diagnosed with stage 4 prostate cancer every year.

Prostate Cancer UK used various data sets to find out the proportion of patients diagnosed with metastatic prostate cancer – which in most cases is too advanced to cure.

The charity found the proportion of men diagnosed at stage 4 was:

  • 35% in Scotland.

  • 20.1% in the North East and Yorkshire.

  • 20% in Northern Ireland.

  • 19% in Wales

  • 17.8% in the Midlands.

  • 17.1% in the North West.

  • 16.8% in the South West.

  • 15.6% in the East.

  • 14.7% in the South East.

  • 12.5% in London.

The data suggests men from deprived areas are at higher risk of being diagnosed at a later stage of the disease, the charity added.

While the figures are largely taken from information gathered before the pandemic, the charity suggested that outcomes for men are not likely to have improved during the period when the health services across England, Northern Ireland, Wales and Scotland have been under significant pressure.

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Ms Kerby said: “Every man should get an equal chance of a cure, which is only possible if his cancer is caught early.

“Unfortunately, early prostate cancer usually doesn’t have any symptoms, which is why men need to be aware of their risk and should take our online risk checker to find out more.

“If you’re at higher risk – which includes all men over 50 – you’re entitled to a free PSA blood test from your GP.

“Because of their higher risk, we strongly recommend that black men and men with a family history of prostate cancer should speak to their GP from the age of 45.”

The charity has also raised concerns about fewer patients being diagnosed during the pandemic.

Ms Kerby added: “At one point in the pandemic, prostate cancer made up a third of all missing cancer cases, so it’s fantastic to see that we’re beginning to find and treat these men.

“However, there is still a long way to go to fully reverse the impact of the pandemic, and as these figures show our job isn’t done even then.

“That’s why we need a screening programme for prostate cancer, and we are committed to funding the research to make this a reality and save thousands of men’s lives.”

Symptoms of prostate cancer according to the NHS

Prostate cancer

The NHS website says prostate cancer usually develops slowly, so there may be no signs for many years.

Symptoms of prostate cancer do not usually appear until the prostate is large enough to affect the tube that carries urine from the bladder out of the penis (urethra).

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What symptoms may be associated with prostate cancer?

  • needing to pee more frequently, often during the night

  • needing to rush to the toilet

  • difficulty in starting to pee (hesitancy)

  • straining or taking a long time while peeing

  • weak flow

  • feeling that your bladder has not emptied fully

  • blood in urine or in semen

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Are these the only symptoms of prostate cancer?

The NHS website says that these symptoms do not always mean you have prostate cancer. Many men's prostates get larger as they get older because of a non-cancerous condition called benign prostate enlargement.

Signs that the cancer may have spread include bone and back pain, a loss of appetite, pain in the testicles and unintentional weight loss.

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What are the causes of prostate cancer?

The NHS says it's not known exactly what causes prostate cancer, although a number of things can increase your risk of developing the condition.

These include:

  • Age – the risk rises as you get older, and most cases are diagnosed in men over 50 years of age

  • Ethnic group – prostate cancer is more common in black men than in Asian men

  • Family history – having a brother or father who developed prostate cancer before age 60 seems to increase your risk of developing it; research also shows that having a close female relative who developed breast cancer may also increase your risk of developing prostate cancer

  • Obesity – recent research suggests there may be a link between obesity and prostate cancer, and a balanced diet and regular exercise may lower your risk of developing prostate cancer

  • Diet – research is ongoing into the links between diet and prostate cancer, and there is some evidence that a diet high in calcium is linked to an increased risk of developing prostate cancer

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What you should do if you're worried about prostate cancer

If you have symptoms that could be caused by prostate cancer, you should visit a GP.

There's no single, definitive test for prostate cancer. The GP will discuss the pros and cons of the various tests with you to try to avoid unnecessary anxiety.

The GP is likely to:

  • ask for a urine sample to check for infection

  • take a blood sample to test your level of prostate-specific antigen (PSA) – called PSA testing

  • examine your prostate by inserting a gloved finger into your bottom – called digital rectal examination

The GP will assess your risk of having prostate cancer based on a number of factors, including your PSA levels and the results of your prostate examination, as well as your age, family history and ethnic group.

If you're at risk, you should be referred to hospital to discuss the options of further tests.

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Men have been urged to check their risk of disease online, and anyone with concerns about prostate cancer can also contact Prostate Cancer UK’s specialist nurses on weekdays on 0800 074 8383.