Jeremy Clarkson reveals prostate cancer news – 5 things men over 60 need to know about the disease
By Camilla Foster, PA
Former Top Gear host-turned-farmer Jeremy Clarkson opened up about his “aggressive” cancer diagnosis in the latest episodes of his popular Amazon Prime Clarkson’s Farm series.
Talking to farm manager Kaleb Cooper and land agent Charlie Ireland during discussions about harvest planning in episode seven, Clarkson said: “I’ve got cancer.
“I disappeared off the other week and had a biopsy done and it is cancer, and it’s aggressive.”
In the following episode (eight) Clarkson chatted to Kaleb following his treatment and revealed that the cancer was in his prostate.
He said: “I won’t know whether it’s worked or not until November probably.
“You know the prostate? 10% of it is dead… the 10% with the cancer in it.”
These new episodes and fresh insights into Clarkson’s health have launched the topic of prostate cancer back into public discussion, so we have spoken to some experts who have highlighted five things that every man over 60 should know about the disease…
1. Age is a significant risk factor
“Prostate cancer is caused when the cells within the prostate mutate to a point where they’re not growing normally, and they start to grow much more quickly,” explains Amy Rylance, director of health services, equity and improvement at Prostate Cancer UK.
“What we know is that as we age, those mutations happen more frequently in our bodies, so that’s why across many different cancers your risk of cancer goes up as you get older.”
Tim Woodman, medical director for cancer services at Bupa, agrees and adds: “The incidence [rate and risk] of prostate cancer really starts to pick up once you get into your 60s and peaks between 75 and 79.”
However, he highlights that it is still possible for young men to get this disease.
“Quite often very old men get prostate cancer which is not terribly aggressive, and in some respects that’s where prostate cancer is a bit like breast cancer – the younger you get it, the more likely it is to be aggressive,” says Woodman.
2. You can check your risk online
“Prostate Cancer UK has an online risk checker that asks about your age, your ethnicity and about whether you have a family history of prostate cancer. It can then give you some more personalised information,” says Rylance.
“The general population’s risk goes up from the age of 50, but if you are one of the men at higher risk of prostate cancer – either because you are a black man, or because you have close relatives who’ve had prostate cancer, or because you have the BRCA gene variant in your family – the risk starts younger.”
3. Prostate cancer often doesn’t present with symptoms in the early stages
“One of the biggest problems with prostate cancer is that, if you think about the fact that the prostate gland is about the size of a walnut and the prostate cancer can be the size of a small pea inside that walnut, once it starts growing it may not produce any symptoms at all because it doesn’t really enlarge the prostate gland to start with,” says Woodman.
However, he emphasises that if you experience any unusual or recurring urinary symptoms, it’s important to flag them to a GP.
“If, every night, you’re suddenly getting up three or four times to pee rather than just once, that’s worth checking out, and if when you go for a pee the stream is not as good as it was, that is also worth checking out,” advises Woodman.
“If you struggle [while peeing] to get started, or struggle to stop, or you leak, or you see blood in your urine, that all needs checking out. Furthermore, if you see blood in your semen, that needs looking at.
“None of these things necessarily means you’ve got prostate cancer because things like bladder infections can also cause those symptoms, but they’re all signals that highlight that you need to be checked.”
He encourages men to not stick their “heads in the sand” about their symptoms.
“The traditional male thing is to stick our heads in the sand, as we often assume this is all just a sign of getting older, or because we’re [overweight] or are on the wrong diet, but ignoring these symptoms is a really bad idea,” says Woodman.
4. You don’t need to have a rectal examination
“Men often associate going to the doctor with a concern that they might have prostate disease with having a rectal examination, and this worry about a ‘finger up your bum’ test is one of the biggest blockers to men going and seeking help,” says Woodman.
“However, men need to know that this is no longer recommended and the professional body for surgeons, the British Association of Urological Surgeons, says it’s not a good test because you can only examine part of the prostate gland because of where it sits, and most doctors don’t know what an abnormal prostate gland feels like.”
Therefore, a PSA (Prostate-Specific Antigen) blood test is the standard first-line investigation used by doctors to assess prostate health.
“It is testing for a protein that’s produced by the prostate and if it shows that your levels are raised, you would be sent for more tests,” explains Rylance.
“You might be referred for an MRI scan which takes a really high-definition picture of the prostate to see if there’s any cause for concern. Then, if there’s something suspicious on that image, a doctor would do a biopsy and take a small sample to see if there any signs of cancer in there.”
Rylance recommends testing from the age of 50, unless you have other risk factors, such as a strong family history, and in that case she advises to start testing from your mid-40s.
“If you’re a black man, have a family history of the disease and if your first PSA result is above one, those things suggest that your risk might be a little bit higher, so a test every 12 months would be a good idea,” advises Rylance. “But if you just have an average risk, then a test every two to three years is probably fine.”
5. It is treatable
The treatment varies according to the stage of the disease you have.
“Some men who are diagnosed with prostate cancer have a type of cancer that’s so slow-growing, treatment will probably cause them more bother than the cancer ever would,” says Rylance. “So, for those men, they would be recommended to have active surveillance where the cancer is monitored.”
However, if the cancer shows signs of growing or progressing, then other treatments are offered.
“If the cancer is still localised within the prostate, there are options now around focal therapy where, instead of treating the whole of the prostate, you’re just treating the area that is cancerous,” says Rylance.
“But if the cancer is a bit more spread through the prostate, then your options are either to have surgery to remove the prostate or to have radiotherapy to treat that whole prostate area and kill off those cancer cells.
“If the cancer has spread, there are more treatments available such as chemotherapy and hormone therapy, but they do have more side effects.”