Jeffrey Archer is to be admired for being so candid about his impotence

His revelation raises important questions about the treatment of prostate cancer

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The Independent Online

Impotence is almost always a private anguish, so for Jeffrey Archer - the multi-million selling author and former deputy chairman of the Tory party – to admit to the condition is certainly brave and to be admired.

Cancer charities were yesterday united in their praise after Archer mentioned what happened to him during the course of a long interview to mark the publication of his latest book.

Last year he had surgery for prostate cancer and wrote about it in a newspaper article in which he highlighted the risks. The side effects of a radical prostatectomy, as the operation is known, are well established: a 50 per cent chance of impotence and a 20 per cent chance of incontinence. 

It is not easy for any man to admit that he has lost this most fundamental of capacities. “You still get the urge, but you can’t do anything about it,” Archer was quoted as saying. “You live with it like anything else. Get on with it.”

Archer’s openness may help other men face up to their fears, and for that his frank admission has been welcomed, and rightly so. But it highlights a separate but important issue is an operation always necessary?

We cannot know the details of Archer’s personal medical history. What we do know, however, is that many men diagnosed with prostate cancer have a slow-growing kind that does not need surgical removal. They live with it, rather than die from it.

For these men, surgery exposes them to needless risk. It is therefore critically important to establish what kind of prostate cancer they have – a slow-growing cancer or one that’s much more aggressive.

For those fortunate enough to have the slow-growing kind, “watchful waiting” is now the preferred approach. This involves regular monitoring of their cancer to ensure it is not transforming into the aggressive sort. In this way they can expect to live a normal lifespan and die of something else.

There has been a 50 per cent rise in the number of men diagnosed with prostate cancer in the last 20 years thanks to greater awareness and wider use of a blood test. But there is still professional disagreement over how best to treat them.