Legendary singer and actor Sir Cliff Richard has publicly spoken out about how he was diagnosed with prostate cancer after a health check ahead of a tour, revealing he has been receiving treatment for the past year.
The 85-year-old singer said his cancer had “gone at the moment” and backed calls for a national screening test for men in an interview on ITV’s Good Morning Britain.
During the interview, Richard said: “I don’t know whether it’s going to come back. We can’t tell those sort of things but we need to, absolutely, I’m convinced, get there, get tested, get checked.”
The singer – who is known for decades of hits including The Young Ones, We Don’t Talk Anymore and Summer Holiday – said he was diagnosed after a health check for his insurance ahead of a concert tour of Australia and New Zealand.
In light of this news, we spoke to Amy Rylance, assistant director of health improvement at Prostate Cancer UK, about how the risk of prostate cancer changes as we age. She also highlighted some other risk factors to be aware of.
What causes prostate cancer and how does age play into this?
“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 Rylance. “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.”
At what age do cases of prostate cancer tend to peak?
“What we can see very clearly is there’s a steep upward trend up to the age of 74 and then it starts to drop down,” says Rylance. “So, each year you get older (up to the age of 74) it becomes more likely that you will be diagnosed with prostate cancer and beyond that it starts to come down again.
“The reason that this goes down is that beyond that age people have lots of other competing health conditions above this age or are not living beyond that stage.”
What are some other factors that can increase your risk of prostate cancer?
“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.”
Is it possible to get prostate cancer under 40?
“One of my team did some analysis on looking at diagnoses of men under the age of 40, and in the whole country found on average about 10 diagnoses each year under the age of 40,” says Rylance. “So, it’s very, very rare before the age of 40, and even in that 40 to 44 age category, it’s still pretty rare. It starts to noticeably pick up from the age of 45 and for most men, that risk picks up from the age of 50.”
What is a PSA test and how often should you be doing them?
“The best test for prostate cancer is the PSA blood test,” says Rylance. “It’s 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.
“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, that 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.”
What are some signs of prostate cancer?
Although prostate cancer is often referred to as a “silent disease” because most men with early-stage prostate cancer do not experience any symptoms, there are some signs to get checked out.
“Symptoms that people often associate with prostate cancer are problems peeing – such as stop-start peeing, urgency, needing to go a lot at night, etc,” says Rylance. “But, what’s tricky about this is that as people get older, those symptoms are incredibly common.
“But if people are having problems peeing, we would always encourage them to go and speak to their GP because these things are often caused by things that are treatable and addressable. Signs of blood either in pee or in semen should also be checked out.”
More advanced prostate cancer can cause bone pain.
“It tends to spread into the bones, so people can experience hip pain or lower back pain,” notes Rylance. “Again, that’s an incredibly common problem in older adults, so we are not suggesting that everyone who has hip pain is going to have advanced prostate cancer, but it’s always worth going to speak to your doctor about these things.”
What types of treatments are offered for prostate cancer?
“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.”
