‘Months of anxiety’ – man had 18 months of prostate cancer tests before getting all-clear

A retired councillor has said he endured 18 months of anxiety before he was declared clear of prostate cancer.

Richard Westlake, 74, was first alerted in November 2015 that his night-time trips to the toilet may be a sign of the condition, combined with a raised prostate-specific antigen test.

Mr Westlake, from Exeter, then faced months of hospital visits, first for a biopsy, then for a more invasive biopsy procedure, along with X-rays and a combination of other tests, each followed by an anguished wait for the result.

The retired Devon County councillor and train driver was finally given the all-clear in June 2017 after a second biopsy.

“I was quite surprised to be honest,” he said of the result.

“I’d been expecting it to be positive, all that time. But I wasn’t celebrating – I’d been through a very difficult time, with all that testing, waiting, unpleasantness and anxiety.

“I knew it had to be done, and all the staff I met were brilliant, but it was a horrible, drawn-out experience.

“Prostate cancer is one of the most common cancers in men, and you think of all the hours of NHS time and resource going into this testing.

“If this new way of assessing patients could cut down on the number of men who have to experience that, I think it would have huge benefits, both to patients and to the NHS.”

Prostate cancer is the second most common cause of cancer death in men in the UK and the five-year survival rate doubles if it is diagnosed at an early stage.

Richard is sharing his story after new research suggested men at the highest risk of prostate cancer could be fast-tracked for investigation if their genetic risk was considered in general practice.

Scientists looked at the impact of incorporating genetic risk of cancer into the GP triage and referral processes.

The research concluded that considering genetic risk could improve referrals for those in need and avoid invasive biopsy investigations for those at low risk of cancer.

Academics at the University of Exeter said GPs make about 800,000 suspected prostate cancer referrals annually in the UK, and by incorporating genetic risk about 160,000 men could be expedited for faster investigation.

They said that by considering genetic risk, 320,000 referrals could be avoided and save men undergoing unpleasant investigations.

Lead author Dr Harry Green said: “Our study is the first to demonstrate that incorporating genetic risk into GPs’ risk assessment of patients’ symptoms of possible prostate cancer could result in faster referral for those at most risk.”

Currently, a prostate-specific antigen test is used to investigate men with erectile dysfunction or urination problems, but the accuracy of the test is unclear and false positive results are common.

Only one in three men with a positive antigen test have cancer and an invasive and unpleasant biopsy is often needed for diagnosis.

The team calculated the genetic risk for prostate cancer using more than 250 known genetic variants linked to the disease.

These genetic variants are combined into a single “genetic risk score” which describes an individual’s genetic risk of developing prostate cancer.

They applied this to data from 6,390 white European men from UK Biobank.

Lead investigator Dr Sarah Bailey said: “This is potentially an exciting new strategy for early cancer detection.

“Not only can high-risk patients be fast-tracked, but those at low risk can safely avoid invasive investigations.

“Using this technique would align well to the NHS Long Term Plan, which pledges to become the first national health care system to offer whole genome sequencing as part of routine care.

“This could be a clear example of improving early diagnosis, and therefore treatment and survival.”

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