The terrible cost of men's silence

Every year it kills 8,500 - more than cervical cancer - yet the health service has ignored it. At last the Government is promising action
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Indy Lifestyle Online

Sometimes it seems there is no limit to George Carman's magic. Appearing on Breakfast With Frost last week, the former QC renowned for pulling rabbits out of hats in the courtroom revealed that the "little local difficulty" which had prompted his retirement was in fact a long-running fight against prostate cancer. He went on to criticise the levels of cancer research in the UK. "We are way behind the major European countries and the States," he said, "and I think it is time that problem was addressed by all the parties."

Sometimes it seems there is no limit to George Carman's magic. Appearing on Breakfast With Frost last week, the former QC renowned for pulling rabbits out of hats in the courtroom revealed that the "little local difficulty" which had prompted his retirement was in fact a long-running fight against prostate cancer. He went on to criticise the levels of cancer research in the UK. "We are way behind the major European countries and the States," he said, "and I think it is time that problem was addressed by all the parties."

Then on Wednesday, as if a wand had been waved, Alan Milburn, the Health Secretary, announced a 20-fold increase in research spending on prostate cancer, bringing government funding to £4.2m by 2004. He also promised that by the end of the year men suspected by a GP of having the disease would be seen by a specialist within 14 days. Among other measures, there would be an extra 95 urologists by 2005 as well as more information for the public.

"Prostate cancer is the cancer we know least about and yet one of the most common," Milburn said. "For too long not enough has been done to detect it or to improve the treatment."

This was something of an understatement. Every year 19,000 men are diagnosed with the disease in the UK and 8,500 die from it - almost as many as the number of women who die from breast cancer and far more than deaths from cervical cancer. It is most likely to strike men over 60, but can occur earlier in life. High-profile sufferers include Rupert Murdoch, Harry Secombe and Roger Moore.

Yet, as Gordon McVie, head of the Cancer Research Campaign, pointed out last week, prostate cancer has been "disgracefully neglected". In 1998, government spending on research into the disease totalled £47,000. Last year, it was a barely more impressive £200,000. Even now, as Carman noted, the new spending, although welcome, compares somewhat unfavourably with the amount being spent on the Dome. "What the electorate wants is money to prevent the death of its citizens rather than to provide leisure facilities," he said.

Nevertheless, the new money is proof that the issue is at last creeping up the Government's agenda, thanks mainly to the charities, patient groups and doctors who have campaigned in recent years to increase awareness. It is surely no coincidence that Milburn's announcement so closely pre- cedes National Prostate Cancer Awareness Week. Organised by a coalition of nine charities, it begins tomorrow with the presentation of a 15,000-name petition at 10 Downing Street calling for an increased level of spending on research, early detection, treatment and support services, notwithstanding the latest increase in funding.

"I think the Government has tried to beat the gun," says Bernard Rawson, chairman of the Prostate Cancer Sufferers Association (PSA), one of the week's organisers. Now 72, he was diagnosed with the disease in 1990. "In those days it was called 'the old man's disease', so the Government did nothing about it because they thought, well, a chap's going to die about 70-odd anyway, so why spend money on it?"

The PSA was formed in 1995 by Angus Earnshaw, who was diagnosed while living in Holland and discovered when he returned to the UK that there was no support group for men with prostate cancer in this country. The association is now a registered charity offering one-to-one and group support. "The first aim was that when a man was diagnosed there was a phone number he could ring, and another man on the end of the line to whom he could talk," says the 76-year-old Earnshaw. "I know how powerless one feels - you're assailed by fear and grief and anger. It's difficult for men to deal with strong emotions. This is one of the reasons why prostate cancer has not had a high profile, because men have found it difficult to talk."

The traditional embarrassment of many men with regard to illnesses affecting their genitals was one of the issues targeted by the Institute of Cancer Research's "Everyman" campaign launched in September 1997. According to the ICR's Alan Horwich, it had a snowball effect. "Questions began to be asked about how much research was going on, and those questions started to come from MPs as well as the public."

Jane Griffiths, Labour MP for Reading East, was alerted to the Everyman campaign by a constituent in 1998. He wrote to her saying that he had prostate cancer but had not visited a doctor soon enough. He was going to live, but his treatment had made him impotent, as can often happen. That could have been prevented if he had been better informed, he said. Eighteen months ago Griffiths set up an all-party working committee on male cancer. She sees the growth of the internet as a significant factor in the growing awareness of the disease. "Whereas men might be worried about some aspect of their health but maybe wouldn't go to see a doctor, they will go on to the internet and see what they can find out about it and they'll find information," she says.

The first newspaper to give prominence to the disease was the Times. In 1997, its editor's father was diagnosed when it was too late for him to have effective treatment and he subsequently died. At the same time the health correspondent, Dr Thomas Stuttaford, was also diagnosed and given treatment. His brother had died of prostate cancer, which has a habit of running in families. The newspaper made the disease the object of its Christmas charity and raised more than £100,000. Then last September the Daily Mail raised £1m with its "Dying of Embarrassment" campaign; the Government pledged to match this in April.

Roger Kirby, a consultant urologist who has worked in the field for 10 years, is cautiously optimistic. He hopes that at last there may be enough money to carry out a study of prostate cancer screening, which might persuade the Government to introduce nationwide screening. In the US, Germany and France, middle-aged men are routinely given a simple blood test that can give an early indication of the disease, but the Government doubts its efficacy.

The big question for Kirby, however, is whether the money will materialise. "This government has a knack of promising extra funding and then nothing much happens," he says. "Until we see the money, we remain quietly sceptical."

* Prostate Cancer Sufferers Association helpline: 0845 6010766. Prostate Cancer Charity helpline: 0845 3008383.

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