Last year I lost two good friends to prostate cancer, both taken before their time.

This awful disease is the most common form of cancer in men in the UK and in 2024 more than 12,000 will die from the disease.

By 2030 prostate cancer is expected to be the most common form of cancer death. Yet it does not have to be like this, an early diagnosis will, in the vast majority of cases lead to a successful treatment.

But we have a conundrum, in the early stages of prostate cancer, there are none of the usual symptoms, such as having to get up for a wee in the middle of the night or lower back pain. And there is no national screening programme. So, it is up to men to be proactive and to arrange an annual PSA test with their doctor from the age of 50.

The Scottish Farmer: Focal Therapy image showing the location of the prostate glandFocal Therapy image showing the location of the prostate gland

The prostate gland is about the size of a walnut and is located near the bladder through which the urethra passes. It is vital for sexual reproduction and for when we go for a wee.

In a healthy male, this organ produces seminal fluid, and muscles within the prostate produce a powerful ejaculation. However, as we get older the chance of cancer increases.

PSA stands for Prostate Specific Antigen which is a protein made by the prostate gland. When the prostate gland is healthy very little protein is leaked into the bloodstream so a raised level should ring alarm bells.

We have three problems to solve before we can help save many unnecessary deaths from prostate cancer.

The first is that there are no symptoms in the early stages of prostate cancer and the second is there is no national screening and the third is that the vast majority of GPs will not call patients in for a routine PSA blood test.

When you contact your GP a small blood sample is taken from your arm usually by the practice nurse and this service is free to all men from the age of 50, or 45 if you are in the higher risk category.

The results take about three working days and are expressed in ng/ml. NHS Scotland gives guidelines upper limits of PSA levels;

Age less than 60 – 3.0 ng/ml

Age 60 – 69 – 4.0 ng/ml

Age 70 – 79 - 5.0 ng/ml

Men in a higher risk group should have a PSA test from the age of 45.

Higher risk groups include;

Men who have a father, brother or uncle with prostate cancer,

Black men or from an Afro-Caribbean ethnicity,

Men with a mother or sister with breast cancer.

Men who have or have had close contact with pesticides, such as a spray operator.

Men who are overweight. (The ideal BMI should be 25).

The Scottish Farmer: Mr Marc LaniadoMr Marc Laniado

It would be a wonderful New Year’s resolution if we could all join in to persuade the men, we know to pick up the phone to their GP to arrange a PSA test.

What happens after the PSA result? Let’s assume four scenarios as a result of a PSA blood test.

First, the results are negative and you have no symptoms, this is a very good day.

Second, the result is positive even after a test and you have a MRI scan at your local hospital. The results show no signs of cancer this is also a very good day.

Thirdly, the MRI scan shows possible cancer lesions on the prostate gland, which requires a biopsy. The results of the biopsy show that there is no cancer – this is also a very good day.

Fourthly, the biopsy confirms the presence of early stage cancer but is contained within the prostate gland. Modern non-invasive treatments such as focal therapy can be 100% effective with little or no side effects. This is also a very good day

Sadly, once the cancer has escaped the prostate and moved to the lymph nodes or the pelvic bones, treatments tend to extend life but they are not a cure.

Chemotherapy and radiotherapy along with hormone treatments can extend life to five years or more.

So, let's all join in and ensure those men we care for book a PSA test today, tomorrow may be too late.

The Scottish Farmer: Gordon RennieGordon Rennie

If your doctor tries to fob you off from having a PSA test, change doctors. Yes, the PSA test is not perfect but it’s the only test we have and is freely available. To all employers out there make sure all your male staff have regular PSA blood tests.

Personally, I will be forever grateful to Marc Laniado a consultant urologist surgeon. Marc Ladiano is one of the UK’s top consulting urologist surgeons so I knew that whatever might happen I would be under the best possible care.

So, when Marc phoned me, he at once put my mind at rest, so whilst he confirmed the presence of cancer, he quickly assured me it was in the very early stages and had caught it in time.

I consider myself very lucky as the non-invasive high frequency ultrasound treatment was 100% successful with no long lasting side effects.

Once you are diagnosed with prostate cancer then the prostate journey begins and there are no road maps.

Marc cured my prostate cancer by non-invasive high frequency ultrasound surgery at the Princess Grace Hospital in London.

I have referred several friends to Marc all with equally good outcomes.

If you want to watch and listen to Marc, go to www.sageurology.co.uk