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Ask The Doctors: Saliva Tests Being Developed To Identify Prostate Cancer

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'I Wouldn't Be Here Without Prostate Test'

Brian Wernham is halfway through cancer treatment

A man who first discovered he may have prostate cancer after buying an online test has called on others to be proactive about the health risk.

Cumberland councillor Brian Wernham, who is halfway through a three-year treatment course, urged men to get tested for the disease.

He said he believed he was only alive today because he had taken the issue into his own hands.

Prostate Cancer UK said men over 50 in the UK had the right to a blood test which could help spot the disease, but outdated guidelines prevented GPs from starting those conversations. The Department for Health has been approached for comment.

Mr Wernham said he had gone to his GP about two years ago with complaints about fatigue and was prescribed antidepressants.

"You think 'I'm turning 60, maybe it's just getting old'," he said.

After speaking to an American urologist online about an unrelated issue, Mr Wernham was advised to get a prostate-specific antigen (PSA) test, which can identify high levels of the protein and point towards prostate cancer.

But PSA levels can be high for a variety of reasons, including an enlarged prostate, or remain normal despite cancer.

'I wouldn't be here'

Mr Wernham said his GP had put him on a non-urgent waiting list for the test when he asked about it.

"After I put the phone down, I went on to Amazon and just typed in PSA test," he said.

The £7.90 finger-prick test suggested Mr Wernham might have prostate cancer.

The councillor was then able to convince his GP to send him to a cancer referral unit, where he was diagnosed with stage three prostate cancer.

"I wouldn't be here if I had not done the test," he said.

Prostate Cancer UK said current NHS guidelines meant it was "each man's responsibility to find out his own risk and to ask for a PSA test himself".

The charity does not recommend home-testing kits, as they do not come with professional follow-ups, and urged men to speak with their GPs.

Paul Atkinson is urging all men over 50 to get checked for prostate cancer

Paul Atkinson from Blyth, Northumberland, also has prostate cancer, but it is too late for it to be cured in his case.

He was told on his birthday in 2022 his cancer had spread and he had between two and five years to live, although he is responding well to treatment.

"I was waking up to go to the bathroom more often but I just didn't realise that was one of the symptoms," he said.

"People of my generation, and my father's generation, didn't talk about things like that.

"Now I urge every man, especially if they're over 50, to get checked."

More stories from across the BBC

Charity wants testing of men at high risk of prostate cancer

Prostate Cancer Questions Answered, From PSA Levels To Treatment Decisions

An expert answers prostate cancer questions from a recent CURE Educated Patient Summit.

Answers to common questions about prostate cancer, including treatment options, side effects, and decision-making.

A diagnosis of prostate cancer can be accompanied by plenty of questions for patients, caregivers and loved ones. Here are expert answers to some such questions from the CURE Educated Patient Prostate Cancer Summit chaired by Dr. Kelly L. Stratton of Oklahoma University Health.

When giving hormone therapy following recurrence, does the doctor recommend starting with Casodex [Bicalutamide] to minimize the risk of testosterone [tumor] flare [as is often done prior to initial hormone therapy]?

That depends on the amount of disease that a patient has. If they don't have documented metastases in the bone, sometimes we can start ADT without Casodex. Some agents, such as Orgovyx [relugolix], do not cause flare.

Is active surveillance appropriate for favorable intermediate risk [prostate cancer] [i.E., Gleason 3+4]?

This is based on several different factors, such as PSA, number of cores positive, cancer location, age and other health issues. Recently, more men have selected active surveillance, particularly those with good quality of life who want to avoid side effects. It is important to continue to monitor closely so additional treatment can be provided if it is needed.

Learn more from the CURE® Educated Patient® Prostate Cancer Summit

Having an enlarged prostate and prostate cancer, is a person more apt to fully empty the bladder after focal therapy?

Most men feel some improvement in stream after treatment. Occasionally it makes it harder to urinate or causes urge to urinate.

Glossary:

ADT: Androgen Deprivation Therapy, or ADT, is a term used to describe the most common hormone therapy for patients with prostate cancer, treatments that reduce androgen production by the testicles.

Gleason score: The Gleason score, ranging from 6 to 10, measures the grade of the cancer, with higher numbers meaning it is more likely the cancer will grow and spread.

PSA: Prostate-specific antigen, or PSA, is a protein which is associated with the presence of prostate cancer in the patient's body.

If you don't know if you want radiation or surgery or focal treatment, what doctor do you talk to? Won't a surgeon suggest surgery and a radiologist suggest radiology, etc.? Who can help you make a decision?

That happens sometimes, but usually a cancer specialist will provide all the possible options and the pros/cons of each.

Why would PSA results increase, but the MRI showed no sign of cancer?

There are several reasons that PSA may increase but are not caused by prostate cancer. One of the most common is an increase in the size of the prostate. Sometimes we pick this up on the MRI. Also, inflammation or infection can cause increased PSA.

If no cancer has been detected after 10-plus years of elevated PSA, does that mean it's unlikely to be detected?

That's a great question. Men can have an elevated PSA and a rising PSA. And those can be caused by different conditions. Often a rising PSA could indicate a problem like cancer. A stable elevated PSA may indicate other causes, such as enlarged prostate or inflammation.

[What about] recurring prostate cancer gradual PSA rise over 16 years [of] treatment?

We [see] this happen, especially in men who have received treatment in the distant past. Not all men need additional treatment. Some can continue with observation and monitoring. The change in PSA over time and imaging findings can help guide next steps. 

For more news on cancer updates, research and education, don't forget to subscribe to CURE®'s newsletters here.

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