After nearly 14 years of medical training and more than three decades working as a hospital consultant, Dr Stephen Allen felt well equipped to recognise the signs of serious illness in his patients.
But when the Reading-based father of two noticed subtle changes in his own body, he immediately dismissed them.
‘I realised I had started needing the loo much more frequently during the night, and when I went, I felt I wasn’t completely emptying my bladder,’ Stephen explained.
Then 58, Stephen knew from his medical training that it was common for men of his age to develop similar symptoms.
As men get older, the prostate – the walnut-sized gland in the pelvis responsible for producing semen – naturally enlarges, putting pressure on the bladder and urethra.
This, he assumed, was likely what was happening to him. ‘I was convinced it wasn’t anything serious,’ he said. ‘So I didn’t bring it up with my doctor.’
It is a decision that has plagued him ever since.
It took his symptoms worsening significantly for Stephen to finally raise the issue with his doctor two years later. Within weeks, he received devastating news – he had prostate cancer.
When Dr Stephen Allen noticed subtle changes in his body he immediately dismissed them, but after raising the issue with his doctor two years later he was told he had prostate cancer
More than 64,000 men are diagnosed with prostate cancer every year in the UK – making it the most common cancer among men
Now, nearly two decades on, Stephen, 77, is cancer-free. But the extent of the surgery required to remove the disease left him almost totally incontinent and struggling with severe sexual dysfunction.
‘I wish I had taken the symptoms more seriously much earlier. And I was a trained doctor. For so many men, they may not even know to recognise them in the first place,’ he said.
More than 64,000 men are diagnosed with prostate cancer every year in the UK – making it the most common cancer among men – and it kills more than 12,000 annually.
Former Top Gear host Jeremy Clarkson made headlines earlier this month when he announced he had been diagnosed with an ‘aggressive’ form of the disease.
‘If I hadn’t got myself checked out, this could well have been my last harvest,’ he said on an episode of his TV show, Clarkson’s Farm.
‘It’s only because they did catch it early – there’s every hope that I’ll be harvesting this farm for many years to come.’
Because prostate cancer is best treated in its earlier stages, before the disease has a chance to spread, early diagnosis is crucial.
And due to the prostate’s location – the gland sits just below the bladder and wraps around the urethra – the most common early signs are urinary symptoms.
Due to the prostate’s location the most common early signs of the disease are urinary symptoms
This could include a change in the frequency of urination, sudden urges – having to rush to the loo – or difficulty urinating, known medically as hesitancy.
Straining or taking a long time to empty the bladder, a weaker-than-normal flow and the feeling that the bladder has not fully emptied are also symptoms of the disease.
Men who experience any of these symptoms should raise them with their doctor, advises Sophie Smith, senior specialist nurse at Prostate Cancer UK.
‘Prostate cancer symptoms often start to appear as the disease becomes more advanced, including changes in the way you urinate, or pain in your back, hips or pelvis,’ she said.
‘These symptoms can all be caused by other health problems, but it’s still a good idea to tell your GP about any symptoms so they can find out what’s causing them and make sure you get the right treatment, if you need it.’
The first step in diagnosis is a blood test to measure prostate-specific antigen (PSA) – a protein produced by the prostate in higher amounts if there is a problem with the gland.
If this shows concerning levels, patients are referred for an MRI scan of the prostate and, if this reveals abnormalities, a biopsy.
While there is no national prostate cancer screening programme on the NHS, all men aged 50 or over can request a free PSA test from their GP.
Men considered at higher risk – whether because of a family history of the disease or their racial background, as black men are at twice the risk – can get a PSA test from the age of 45.
And anyone experiencing symptoms should be offered a PSA test, regardless of age, according to guidelines.
Ms Smith said: ‘It’s important to remember that prostate cancer often has subtle symptoms in its earlier, more treatable stages, so it’s crucial for a man to understand his own risk and not ignore warning signs.’
In Stephen’s case, tests revealed his PSA levels were high – but not elevated enough to warrant further investigation.
Today, Stephen is working with Tackle Prostate Cancer to raise awareness around the disease and to encourage men to speak amongst themselves about symptoms
The result was enough to reassure him that his symptoms were nothing to worry about.
‘I knew that what I was experiencing could be symptoms of the disease,’ said Stephen. ‘As a consultant anaesthesiologist, I worked closely with the hospital’s urology department, who were constantly treating men with prostate cancer.
‘But I just didn’t believe that I could have it myself. Things like going to the loo a lot at night happens gradually, and you just get used to it.
‘So I kept my mouth shut about my symptoms, which was stupid. You’d think as a doctor, I’d have a better idea than most, but one of the downsides is thinking you know more than you.’
The severity of Stephen’s disease meant the best available treatment was a radical prostatectomy – the removal of the entire gland.
The surgery was a success – and Stephen was declared cancer-free.
But the extent of the operation left him with debilitating side effects.
‘I was almost completely incontinent,’ he said. ‘I had to wear pads all the time, and change them six to seven times a day, which really damaged my self-confidence – especially when I would have to undress in communal spaces, like the gym,’ he said.
Stephen also had significant erectile dysfunction after his surgery, which has now improved with ‘pharmaceuticals, patience and humour’, he says.
A year and a half after surgery, Stephen was offered a life-changing implant that solved his incontinence.
And today, he’s working with Tackle Prostate Cancer to raise awareness around the disease and to encourage men to speak amongst themselves about symptoms, including making videos speaking about his experience as part of the Unmentionables campaign.
‘Jeremy Clarkson put into words what others would like to have said,’ said Stephen. ‘Men need to speak up about prostate cancer, and get themselves tested for it.
‘I’m a doctor and I ignored my symptoms of significant prostate problems for two years before doing anything about it.
‘We need more people to be speaking openly about it.’
