NHS to review guidance on prostate cancer testing after Chris Hoy’s appeal

NHS to review guidance on prostate cancer testing after Chris Hoy’s appeal

The NHS is to review its guidance on testing for prostate cancer in light of Sir Chris Hoy’s “powerful” call for more men to be screened, the Health Secretary has said.

Olympic cycling champion Sir Chris, who has terminal cancer, is urging men with a family history of the disease to consider seeing their GP, and for more men to be aware of the prostate-specific antigen (PSA) blood test to check for the disease.

Both Sir Chris’s grandfather and father had prostate cancer, which can run in families.

“If you’ve got family history of it, like I have, if you’re over the age of 45, go and ask your doctor,” Sir Chris told BBC Breakfast.

“I’ve got a friend who, when I told him my news early on confidentially, he went and got a PSA test and it turned out he had cancer. He’s had treatment and he’s been given the all-clear.”

He said men should be able to get a screening test when they are younger, with no barriers to accessing one.

“Catch it before you need to have any major treatment. To me it seems a no-brainer. Reduce the age, allow more men to just go in and get a blood test.

“Maybe people seeing this or hearing about my story – just by them asking their GP – will create enough of a surge of interest that people that make the decisions will go ‘You know what, we need to address this’. And in the long term this will save potentially millions of lives.”

NHS guidelines for England say anyone can request a PSA test if they are over the age of 50.

The charity Prostate Cancer UK also advises that black people or those with a family history of prostate cancer may want to speak to their GP about having a PSA test from the age of 45.

GPs are currently told to use their clinical judgment for men aged under 50 without symptoms who they consider to be at increased risk of prostate cancer.

Men with symptoms of any age can request a test.

The PSA test on its own is not currently recommended as a screening test for prostate cancer because, although a high level of PSA can be a sign of the disease, PSA levels can also be raised because of other things like a urine infection.

The PSA test also misses some prostate cancers – one in seven men with a normal PSA result actually have the disease.

Newer, more accurate tests are being developed.

Asked about Sir Chris’s comments, Health Secretary Wes Streeting told BBC Breakfast: “I think he makes a powerful argument there.

“That’s why I’ve asked the NHS to look at the case for lowering the screening age on prostate cancer, and (he) even makes a particularly powerful case where there’s family history.

“I’m sure his appeal to people who’ve got a history of prostate cancer in their family to maybe think about asking for an earlier check will already be heeded by people watching.

“And the final thing I think he’s already made a difference on, is there will be lots of people out there living with cancer at the moment, either themselves or someone they love… and the way in which he has spoken so openly and full of optimism about his own journey with cancer, I think, will have given hope and inspiration to millions of people across the country.

“So, I can tell Chris we are now actively looking at the case – we’ve obviously got to be evidence-led, (have) clinically led decisions… but we are acting actively looking at it as a result of his intervention.”

Data shows that men who have a brother or father with prostate cancer are 2.5 times more likely to develop the disease and the risk increases even further if they were under 60 when diagnosed.

Chiara De Biase, director of health services, equity and improvement at Prostate Cancer UK, said: “We’re grateful to Sir Chris for so bravely and openly telling his story this morning, and we welcome news that the Government is now actively looking into testing men who have a family history of prostate cancer from the age of 45.

“One in eight men will get prostate cancer but there’s currently no screening programme for the disease.

“If your dad or brother has had prostate cancer, or you’re black, you have the highest risk of getting the disease, and we strongly recommend you talk to your GP about testing from 45.

“Right now, you need to be aware of this and bring it up with a GP yourself. As prostate cancer often has no symptoms in its earlier stages this is leading to too many men getting a late, incurable diagnosis – like Sir Chris.”

Elsewhere in the BBC interview, Sir Chris told of the “absolute shock and horror” he felt at his initial diagnosis, the “nightmare” of learning wife Sarra had multiple sclerosis, and having to break the news to their two young children.

“It was the biggest shock of my life. I remember the feeling of just absolute horror and shock,” he said.

“I just basically walked back in a daze. I couldn’t believe the news and I was just trying to process it, I don’t remember walking.

“I just remember sort of halfway home thinking ‘Where am I?’ And then I was thinking ‘How am I going to tell Sarra? What am I going to say?'”

When he was given the news that his cancer was terminal, Sir Chris explained his emotions.

“Suddenly, everything, all your thoughts, everything rushes. It’s almost like your life is flashing before your eyes in that moment.

“It does feel like this isn’t real. You feel that you want to get out, you feel like you’re a caged animal, you want to get out of that consulting room and get away from the hospital and run away from it all.

“But you realise you can’t outrun this, this is within you and this is just the first step of the process of acceptance.”

He said his first thought was how he would break the news to his two young children.

Sir Chris Hoy
Olympic cycling champion Sir Chris Hoy said ‘the stakes are much higher now’ (Stephen Pond/PA)

He said: “How on earth are we going to tell the kids? It’s just this absolute horror, it is a waking nightmare, living nightmare.

“We just tried to be positive and tried to say ‘Do you know what? This is what we’re doing and you can help because when I’m not feeling well, you can come and give me cuddles, you can be supportive, you can be happy, you can be kind to each other’.”

On his Olympic wins and his career, Sir Chris said: “The stakes are much higher now. It felt like life and death in the moment when you were battling it out for an Olympic gold medal but the stakes have changed dramatically and it is life and death.

“But the principle is the same – it’s about focusing on what you have control over and not worrying about the stuff that you can’t control.”