WHEN Sir Chris Hoy announced the devastating news that he has terminal prostate cancer and has only a few years to live, everyone was aghast. How could one of the greatest and most popular sporting figures of our times fall victim to this savage disease? Why had medical treatment not overcome it? And how, in the face of such a prognosis, does he remain so positive, seeming to think more about others than himself?

Cancer, as Sir Chris’s story shows, does not defer to age or fitness. Tragically, it can affect anyone, in their prime as well as in their dotage. In Hoy’s case, even though he is only 48 and super fit, it was caught too late. Who knows what the outcome would have been had it been detected five years earlier. That, no doubt, is one of the reasons why he recently spoke passionately about the need for earlier screening for prostate cancer for men with a family history of the disease.

In a BBC interview Hoy, whose grandfather and father had the condition, said: “If you’ve got family history of it like I have, if you’re over the age of 45, go and ask your doctor. Maybe people seeing this [interview] or hearing about my story – just by them asking their GP – will create enough of a surge of interest that people that make the decisions will go, ‘You know what, we need to address this.’ And in the long term this will save potentially millions of lives.”

Statistics show that a man with a brother or father with prostate cancer is at 2.5 times greater risk than average, that figure rising if his relative’s cancer was diagnosed before the age of 60 (It’s worth noting there can also be a genetic link between prostate and breast cancer, with one study showing a 14% higher risk for women whose father, brother or son has it).

Following Hoy’s public plea, Wes Streeting, the UK Health Minister, has asked the NHS to consider the benefits of lowering the screening age, commenting that Hoy “makes a powerful argument”. Since this form of cancer is the second most common cause of death in men in the UK (the main cause is heart disease), there is plainly a need for greater urgency and rigour in the way it is detected.

At present there is no national screening programme, even though getting men into treatment early would give them a good chance of a much longer life. Anyone with symptoms, whatever his age, can of course ask to be tested, but that is no help to those who have no reason to suspect they have cancer, and remain unaware of it for far too long. Currently, testing for those without symptoms is not considered until the age of 50 and beyond. To make a tricky situation even worse, according to the reputable website Prostate Matters, in the majority of cases there are no symptoms.

Compare this scenario to that of women with a family history of breast cancer. As 
I know from personal experience, such women are annually screened, from as young as their twenties. The problem with prostate cancer, however, is not medical apathy or neglect but the fact that it is not easily detected. 

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At the moment, the first line of defence for anyone who is worried is to see a GP. They will do a simple physical examination, followed by a blood test to determine levels of prostate-specific antigen (PSA) which, if elevated, might be an indication of cancer. Or not, as the case may be. Innovative and potentially more accurate tests are being trialled, which might make the process easier and more reliable, but they lie in the future.

Yet even if there was a major breakthrough in testing efficiency, that doesn’t address the issue of how to get men at higher risk into the surgery when they don’t think there’s anything wrong with them. Anxiety over being considered a hypochondriac plus embarrassment about being examined are serious obstacles to detection. Although I don’t usually like to generalise about differences between the genders, there’s plenty of evidence to suggest men are often more reluctant than women about going to the doctor. Indeed, it is thought one of the reasons men with female partners live longer than single men is because these women encourage them to make an appointment. It’s called nagging.

Without doubt, some men’s resistance to seeing a doctor arises from dread. The C-word strikes terror into everyone’s heart. Indeed, so great is some people’s fear that they convince themselves there is no problem until it becomes impossible to ignore, by which point their condition might be well advanced.

(Image: Chris Hoy)

Imagine if the NHS were to roll out a family history screening programme for younger, symptom-free men, from their mid-forties as Hoy suggests. One major hurdle to early detection would be removed. My husband, whose family has a strong history of prostate cancer, did not get tested until he was in his sixties, at which point cancer was discovered. How much more reassuring it would have been, for him and other family members at risk, to have been automatically screened years earlier. This would have put everyone’s minds at rest, knowing that their health was under regular review and swift action would be taken if cancer was found.

Another medical barrier is men’s hesitancy over talking about serious health issues. This is why Hoy’s openness is so impressive and so important. By raising the profile of the disease among younger men, he is encouraging them to discuss it. Hoy has said that after confiding about his illness to a close friend, this man went for tests, and found he too had cancer. Since then he has had treatment and “been given the all-clear”. It was the same with one of my relatives, who urged his pals to get checked out as he had. As a result, some of them discovered they were in the same boat, and were soon undergoing treatment.

Before Sir Chris Hoy’s diagnosis, his legacy as a sporting legend was assured. Now, by speaking out about this cruel disease, he can add to his achievements the certainty that his intervention already has, and will continue to save countless lives that would otherwise have been lost.