MEN’S HEALTH 73
blood. It should be noted that PSA tests
are not considered a helpful tool for
screening the general population. But if,
say, your father had prostate cancer, you
should request one when you’re five years
off the age he was at the time of diagnosis.
“The good thing about the PSA test
is that, while it can create false positives,
false negatives are very rare,” says Declan
Cahill, consultant urological surgeon
at the Royal Marsden. “If you get a PSA
and it’s normal, you’re usually fine. If
not, you get a repeat blood test; and if
that still shows high PSA levels, you get
put on the Two-Week Wait.”
The Two-Week Wait is a government
target for at least 95% of people in the UK
with a cancer symptom – blood in the
urine, a lump on the testicle, elevated
PSA levels – to be seen within two weeks,
diagnosed within a month and treated
within 62 days. After that initial two-week
period, a patient should find himself in
front of a urologist such as Cahill. He’ll
recommend that you have an MRI scan,
before undergoing a biopsy. “Just five
years ago, a prostate could be removed
that actually only had one bad lump in
it,” says Cahill. “It’s only in recent years
that MRI techniques have allowed us
to biopsy where the lump is with good
confidence.” With cells from the biopsy
under a microscope, the medical team
can work out exactly what sort of cancer
it is and form a treatment plan.
This is where it gets complicated.
The treatment you receive depends on
the severity of the growth, your age and
your fitness levels. If you’re deemed low
risk, it might be purely observational.
A more serious case might receive
interventional treatment, which could
mean surgery or targeted radiotherapy. If
it’s very advanced, the focus could be on
non-curative treatment: in other words,
managing symptoms and slowing the
spread of cancer to other parts of the body.
Deciding on a treatment plan can be a
thorny process, and the side-effects are
not insignificant. To simplify hugely: with
surgery, the main risks are incontinence
and an inability to maintain an erection
and ejaculate. Patients can expect anGAME CHANGER # 2
THE ROBOT
Da Vinci Surgical System03
THE INSIDE TRACT
Even the world’s best surgeon
is constrained by the natural
limitations of the human body.
The Da Vinci robot transcends
such restrictions – it has four
arms, for a start. The machine
can make microscopic incisions
to help reduce pain, bruising
and blood loss, while significantly
accelerating recovery times. TheRoyal Marsden is the first NHS
Foundation Trust in England to
introduce two Da Vinci Xi robots,
thanks to funds from supporters
of its charity. Of course, this hasn’t
done away with the need for
the human touch: the robot still
requires a surgeon to operate it
(see left). But the tech is now so
advanced that it can stitch a
peeled grape back together again.
Further proof that patients are
in safe (mechanical) hands.01-02\ Ex machina:
a robot-assisted
prostatectomy at
the Royal Marsden
in London
03 \ The Da Vinci
system, which has
revolutionised
the prostate op by
combining surgical
mastery with tech