Woman who had skin cancer warns of sunbed danger
She said she used oil for sunbathing, adding: "I didn't use high-factor sunscreen or cover up when I was out." In 2022, her partner noticed a white patch on her face.She said: "I thought it was just pigmentation, because it didn't look like a mole or what I took to be the usual signs of skin cancer. "Even the GP thought it was pigmentation. "But I wasn't happy because it just didn't look right so I pushed for some tests."A biopsy revealed she had basal cell carcinoma, the most common form of skin cancer which develops from cells found in the deepest part of the outer layer of the skin.For most people, this type of cancer does not spread.It can be removed by surgery and no further treatment is required. However, Ms Verrall's carcinoma needed a deep and lengthy incision to remove all traces of it.
Around 3,100 people are diagnosed with skin cancer every year in the south-east of England, according to Cancer Research UK.Ms Verrall, who runs an industrial door company, said she is now passionate about urging people to look after their skin."What I went through was traumatising and I don't want other people to experience that," she said.Beth Vincent, Cancer Research UK health information manager, said: "Getting sunburnt just once every two years can triple the risk of developing skin cancer, compared to never being burnt. "Even on a cloudy day, the sun can be strong enough to burn between mid-March and mid-October."
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Telegraph
29 minutes ago
- Telegraph
The six natural alternatives to statins to lower your cholesterol
For those of us in middle age and beyond, conversations about cholesterol are hard to avoid – and with good reason. In England, according to the National Institute for Health and Care Excellence, high cholesterol leads to more than 7 per cent of all deaths and affects six in 10 adults, a number that rises for those in middle age: the most recent NHS Health Survey for England found that in the 45-64 age group, 77 per cent of women and 67 per cent of men had raised cholesterol. Surprisingly, these figures drop in the over-64 age group. Why? Because many of this older cohort are on statins. Statins are currently prescribed to around eight million people in the UK, and taking this daily tablet is a proven way to lower cholesterol levels and reduce your risk of heart attack or stroke. 'We are the first generation of people who have the opportunity to reduce our cardiovascular risk – still the number-one killer – because we have effective treatments in the form of statins,' says Robin Choudhury, a professor of cardiovascular medicine at the University of Oxford, a consultant cardiologist at John Radcliffe Hospital and the author of The Beating Heart: The Art and Science of Our Most Vital Organ. The turn against statins However, for some people with a lower cardiovascular risk, it may be possible to avoid statins by adopting lifestyle changes and/or seeking out other natural options. This is welcome news for many, because statins are often viewed with mistrust. Some critics argue that perhaps these pills are being doled out too liberally and that lots of people shouldn't be on them at all. Others think that statins may even be bad for us. In his 2007 book The Great Cholesterol Con, Scottish GP Malcolm Kendrick argues that high cholesterol levels don't cause heart disease, that statins have many more side effects than has been admitted and that their advocates should be asking more questions. This is something Prof Choudhury finds mystifying. 'I really don't know why people are reluctant to take them,' he says. 'There is one serious side effect associated with statins, called rhabdomyolysis, which is a severe muscle inflammation. But it's extremely rare. It affects one to two patients per 10,000 treated.' 'A lot of people just don't want to take a tablet every day,' suggests Dr Oliver Guttmann, a consultant cardiologist at the Wellington Hospital, part of HCA Healthcare UK. 'People also want to try and do it in what they call the 'natural' way.' The other natural options So, are there other effective natural options to statins? The answer is yes – but only up to a point. 'The bottom line,' says Dr Guttmann, 'is that with all the natural alternatives, there's some effectiveness, but they're not magic bullets.' He accepts, however, that other natural options can play 'a supporting role, especially for those people who are generally healthy and just want to try complementary treatments to decrease mild cholesterol elevation'. If you have been offered statins and decide not to take them, it's crucial to discuss the risks with your GP or cardiologist. Prof Choudhury emphasises that if you've already had a heart attack, angina or stroke, or if your percentage risk of a future event is high, taking statins is usually a sensible route that is grounded in evidence. 'For those who have heart disease, very few people have a good reason not to be on statins. For those who've never had an event, it's important to take an holistic view of risk [incorporating blood pressure, diabetes and family history] but for many individuals, alternatives to statins are perfectly reasonable.' Here are six other cholesterol-lowering options to consider: Plant sterols and stanols Plant sterols and stanols, also known as phytosterols, are naturally occurring compounds that have a similar structure to cholesterol. Prof Choudhury explains: 'They help lower LDL cholesterol levels by reducing cholesterol absorption in the gut because they compete for the same absorption sites.' Found in foods such as vegetable oils, nuts, seeds and whole grains, phytosterols have been shown to lower LDL cholesterol by eight to 10 per cent when eaten regularly as part of a healthy diet. They also work well in combination with statins. However, according to the British Dietetic Association, you need to consume reasonably large quantities – around 2g – each day, with meals, for them to be effective. Most people achieve this by having a plant sterol- or stanol-fortified mini yogurt drink every day or by eating two to three portions of foods with at least 0.8g of added plant sterol/stanol, such as 10g of fortified spread (eg margarines) or one 250ml glass of fortified milk. Oats and barley Oats and barley contain beta-glucans, a soluble fibre, which can be consumed in food or as supplements to regulate blood sugar and lower cholesterol. Cholesterol can go into the blood or the gut, Prof Choudhury explains. 'If you can take that cholesterol out of the gut and stop it being reabsorbed, that has a beneficial net effect on blood cholesterol levels. Beta-glucans bind to the soluble cholesterol that's in the gut and it then exits the bowel.' Some studies suggest that if a healthy adult consumes around 3g of beta-glucan daily – a bowl of porridge – they can decrease their LDL levels by five to 10 per cent over three months. Omega-3s Omega-3 fatty acids do not lower LDL cholesterol, but they have been shown to reduce triglycerides – a different type of fat found in the blood that are deemed to be harmful. Taken in supplement form, omega-3 can lower triglycerides by around 20-30 per cent. 'I tell my patients to take omega-3s all the time,' says Dr Guttmann. 'You find them in oily fish, like salmon and mackerel, though most people take them in supplement form. They work really well taken together with statins to lower your risk of heart disease. They've also been shown to support your brain health, cognitive function and mood.' Red yeast rice Commonly used in traditional Chinese medicine, red yeast rice is sometimes described as a natural statin. 'It blocks cholesterol production in the liver in a similar way to statins,' Dr Guttmann explains. 'The problem is, it's very difficult to get the exact amount you need because the dosages and qualities can vary from one supplement to another. People can also sometimes consume red yeast rice in very high doses, which may cause liver problems.' Prof Choudhury is also concerned by the unregulated nature of red yeast rice capsules, which have been linked to safety issues. 'Statins originated from yeast,' he says, 'and there's a component of red yeast rice [a compound called monacolin K] which has a statin-like action that lowers LDL cholesterol. But it's not a regulated product, so you don't know what you're getting when you take it.' Psyllium husk Psyllium husk is a soluble fibre that helps to lower LDL cholesterol levels. When consumed, it forms a gel-like substance in the digestive tract that traps bile acids and prevents their absorption, causing them to be excreted through the stool. The liver responds by pulling in cholesterol from the blood to produce more bile acids, reducing the amount of cholesterol circulating in the blood. 'Psyllium husk is basically a digestive aid,' says Dr Guttmann. 'It's used as a laxative because it helps regulate your bowel movement, and in the process, it can lower cholesterol and decrease reabsorption. If you take it regularly, it probably reduces your LDL level by about five per cent. So it's great if you just want to be living a healthier lifestyle but inadequate as a medical intervention.' Garlic Some research suggests that allicin, a chemical found in garlic, can lower your blood pressure and cholesterol. One clove (3-6g) of garlic a day may help decrease your LDL by up to 10 per cent, though the evidence is not yet conclusive. 'The problem is that if you just eat fresh garlic, you need to consume a very high amount,' says Dr Guttmann. 'And that's difficult for most people to achieve. So most people take garlic supplements in quite a high dose. I advise people to try this for a while and then re-monitor their LDL to see how they react to it. But it's certainly not a replacement for statins.' And one to be sceptical about… Apple cider vinegar 'The one product often mentioned as an alternative to statins that doesn't really have any significant evidence to back it up is apple cider vinegar,' says Dr Guttmann. 'While it might help to decrease your sugar levels, it does not appear to affect your LDL significantly.' Prof Choudhury concurs: 'I'm not aware of any convincing evidence to suggest that this is effective.' Lifestyle changes to lower your cholesterol 'Our cholesterol level is, to a large extent, genetic,' says Prof Choudhury. 'With lifestyle modifications, you can make some impact on it, though usually not more than 10-15 per cent. For people who don't have very high cholesterol, but have other risk factors, it's a sensible thing to do.' There are five main ways to reduce your cholesterol level without taking statins: Eat a healthy, balanced diet that's high in fibre Exercise regularly Maintain a healthy weight Limit the amount of alcohol you drink Stop smoking For Dr Guttmann, increasing our consumption of dietary fibre is perhaps the quickest and easiest lifestyle change to make. 'Eating a high-fibre diet not only improves your gut health, it also decreases your cholesterol absorption. It binds to the cholesterol in your gut and prevents it being absorbed by the body, which lowers your levels of harmful LDL cholesterol.' He adds: 'My patients often ask me, 'If I do all of these things, surely it's the same as taking a statin?' But the truth is, because they're all working in a similar way, the benefits are not cumulative.' He does concede, however, that it very much depends on the individual. 'I've had some patients surprise me,' he nods. 'By changing their diet and lifestyle and by incorporating some of the interventions in the list above, people can achieve dramatic improvements. But, overall, statins are still the gold standard.'
Daily Mirror
an hour ago
- Daily Mirror
Breast cancer warning issued to all women as common sign won't always appear
More difficult to notice and poorly understood, lobular breast cancer is finally coming under the spotlight but it's not as easy to spot the signs, especially one common one woman look for Lobular breast cancer, also known as invasive lobular carcinoma (ILC), is more common than ovarian and skin cancer yet there is little awareness of it. According to Cancer Research UK, one in seven women will be diagnosed with breast cancer in their lifetime and around 15% of those will have ILC. BBC presenter Victoria Derbyshire, 56, was diagnosed with the disease in 2015. ILC is different to the most common form of ductal breast cancer. Instead of starting in the breast ducts, it starts in the lobules, the glands that produce milk, and grows in a spider's web pattern. Cancer cells infect the tissue around the glands and rarely show in lumps, so it is harder to spot and likely to be diagnosed later. At least a fifth of ILC cases return years later. When this happens, the cancer becomes even harder to treat. And yet it's an under-diagnosed subtype of breast cancer that is underfunded and poorly understood. Kate Ford, a campaigner from the Lobular MoonShot Project (LMSP), says, 'The basic biology of this disease has never been studied and it has no specific treatment. ILC needs a moon shot approach – a fast injection of cash – to research funding.' On 24 June, 22 women led by LMSP Founder Dr Susan Michaelis, who sadly passed away from ILC on 9 July, held a vigil outside 10 Downing Street and delivered a petition backed by more than 350 MPs to the Prime Minister, calling for urgent funding for ILC research. Symptoms to watch out for Lobular breast cancer rarely forms lumps. Instead, the things to look out for include an area of thickening or swelling around the breast, a change in the nipple, for example it becoming inverted, or a change in the skin, such as dimpling, puckering or even a small new mark. Don't ignore other changes Cancer Research UK suggests people should also look out for pain and itching, a new lump in your breast or armpit, a change in the size, shape or feel of your breast, skin changes in the breast such as a rash or redness of the skin, fluid leaking from the nipple in a woman who isn't pregnant or breastfeeding and/or changes in the position of the nipple. If you see any of these symptoms you're advised to visit your doctor. Get a diagnosis Your GP will refer you to a clinic if they believe you might have ILC. They will examine your breasts and check for swollen lymph nodes. They may use a mammogram, an ultrasound if you're under 35, a biopsy or an MRI scan. MRI and biopsy are the most effective detection tools for ILC. Mammograms and ultrasound often fail to show the presence of the disease. How ILC is treated ILC is currently treated with chemotherapy, surgery and drugs to reduce the level of oestrogen, which cancer cells need to grow. Chemo works best on fast-dividing cells, but lobular breast cancer is not fast dividing, so the efficacy of chemo on ILC is not entirely understood. Depending on the size and abnormality, whether cells have receptors for drugs, your general health and age, a doctor will consider the best treatment, but generally it is the same as for the more common types of breast cancer. Hope for the future The Lobular Moon Shot Project is campaigning to raise £20min government funding to carry out vital research on ILC in partnership with the Manchester Breast Centre and led by breast biology expert Professor Rob Clarke.'With this funding, we could potentially develop a drug and begin testing it on patients within the next five years,' he says. "The fear of recurrence is always with me" Lobular Moon Shot Project campaigner, teacher and mum-of-three Katie Swinburne, 49, was diagnosed with ILC in 2023. 'Prior to my diagnosis, I was extremely fit and healthy, and took care with the food I ate. I remember the morning I found a lump very clearly. It appeared overnight after two years of other symptoms including pain and itching. It was extremely large, but in my ignorance I thought it was a cyst. 'I went to see my GP and was sent to have a mammogram, the nan ultrasound. The sonographer felt the lump but was confident there was nothing to worry about. He performed a biopsy to try and establish what the lump was. 'At my next appointment, a consultant came in, followed by a nurse. I was soon to learn the nurse was a Macmillan nurse. I was smiling and chatting away to the consultant, expecting to be sent on my way, when he said, 'We have the results – you have an invasive lobular carcinoma.' 'Hearing the words 'you have cancer' is like nothing else. My life, my body and my future were no longer assured. At the time of my diagnosis, my children were 10, 12 and 14. The thought of leaving them left me breathless. 'A whirlwind of appointments followed, including CT, MRI and DEXA scans. I had a double mastectomy and dose-dense chemotherapy, then radiotherapy. The nurses are angels. They hold your hand through it all. You find reserves you never knew you had. 'The fear of recurrence is always with me. I'm two years on from diagnosis and still too young for screening. Had that lump not appeared, my story might be very different. I think we need to start education and screening at a much younger age.' The Macmillan Support Line offers free, confidential support to people living with cancer and their loved ones. Call for free within the UK on 0808 808 0000
Telegraph
2 hours ago
- Telegraph
The PSA test for prostate cancer – everything you need to know
Prostate cancer is the most common form of cancer among men in England, with cases surging among both men and women by 25 per cent between 2019 and 2023 according to NHS data. It's also the second deadliest form of the disease for men after lung cancer, killing one man every 45 minutes despite being highly curable if caught in time. Yet there is still no formal screening programme for prostate cancer in the UK. In the US, Czech Republic and Lithuania by contrast, screening is offered to men within a certain age bracket via a simple blood test, the PSA test. 'We know that in countries with formal PSA screening programs, the rates of advanced prostate cancer are a lot less,' says Prasanna Sooriakumaran, a professor of urology at the University of Oxford, and a consultant urologist at University College London Hospitals. 'In this country, one in five men with prostate cancer present at an advanced, incurable state whereas in the US, that number is significantly under 10 per cent and that's because of PSA screening.' So what is this test and what does it tell you? What is a PSA test? As David James, the director of Prostate Cancer Research, explains, the PSA test measures the levels of a prostate-specific antigen, a protein made by cells within the prostate. Because cancerous cells can enable PSA to slip more easily out of the prostate and ultimately reach the bloodstream, it can serve as a biological signal for the presence of a tumour. 'High levels don't always mean cancer, but they can be an early warning sign and usually lead to further tests to find out if cancer is present,' says James. 'It's one of the best tools we have right now to help catch prostate cancer early, often before any symptoms appear.' Who can have a PSA blood test? While PSA testing is not routinely available on the NHS, all men aged 50 or over can, in theory, request an appointment with their GP to discuss the possibility of getting a test. Black men over 45 who are at higher risk of prostate cancer because of their ethnicity are strongly recommended to discuss having a PSA test with a doctor, as well as all over-45s with a known family history of the disease. Clément Orczyk, a consultant urological surgeon at University College London Hospitals says that PSA testing is also highly recommended for men who have blood in their urine, problems getting an erection or have begun peeing more than usual, although he urges men not to panic if they are having any of these symptoms. 'Most of the time it's linked to benign prostatic hyperplasia, the normal age-related enlargement of the prostate, not cancer,' he says. What happens during the test? Emma Craske, a specialist nurse for Prostate Cancer UK, explains that the PSA test is taken like any other blood test. While some men are reluctant to come forward for testing because they are worried that it will lead to a digital rectal examination (DRE), she says this is unlikely to happen. Instead, an abnormal reading would lead to an MRI scan being booked at the hospital. 'The MRI scan is far more accurate at identifying abnormalities within the prostate than a DRE,' she says. How do I request a PSA test? Orczyk says that you simply have to book a GP appointment and request one. 'But before asking for a test, it's important to be prepared for the potential consequences of having the test,' he says. 'For example, the fact that you might then need to be referred for further screening, and because the test isn't necessarily specific to cancer, people can be sometimes falsely reassured or falsely alarmed by their results.' Why would I be refused a test? The most obvious reason is because you are not considered eligible, for example under 50 and with no standard risk factors. When such instances happen with men who should be eligible for a test, Sooriakumaran suggests that it may be because the GP is worried about their capability of interpreting a borderline result. 'If the result is grossly abnormal, it's easy for the GP, they send them on to a specialist, and if the result is normal, it's also easy for the GP,' he says. 'But it's that grey area which causes concern.' What can I do if my GP refuses a PSA test? There are an increasing number of high-street providers which offer low cost PSA tests, but Orczyk advises people to steer clear of them, as getting an accurate result requires the use of medically certified laboratories, such as those used by the NHS. Instead, Sooriakumaran recommends pushing back, emphasising your concerns and explaining why you wish to have a test. 'I don't know many GPs these days that would point blank refuse if they were getting pushback,' he says. 'Tell them that specialists would much rather see men who got early curable prostate cancer, then men presenting much later with advanced cancer.' Is there anything I can't do before the test? According to Craske, anal sex and any form of prostate stimulation are out of bounds for a week before the test, while in the 48 hours prior to testing, men should also abstain from vigorous exercise and ejaculation. If you have recently had a urine infection, bladder or prostate surgery, she says it is advised to wait six weeks before having the test. 'You can eat and drink as normal before a PSA test, including alcohol,' says Craske. 'There are a group of medicines used to treat benign enlargement of the prostate that may artificially reduce the PSA level, known as 5-alpha-reductase inhibitors such as finasteride or dutasteride. Patients on these drugs need to have this taken into account when doctors interpret the results.' How long will the results take? Craske says that results usually come back within a week, and can be obtained either via the NHS App or by calling the surgery. She advises asking for the exact figure, even if the result is normal. 'This can be helpful if you choose to have a PSA test in the future, to recognise a trend,' she says. What is a high PSA and what does it mean? Interpreting the PSA test can be complex, according to Sooriakumaran, as the results come with considerable individual variability. There are age-specific reference ranges for PSA because the prostate naturally enlarges and produces more of this protein as we get older. For example, if you are aged between 40-49, a PSA reading of more than 2.5ng/ml may be considered high, while if you are over 70, it would have to be more than 6.5 ng/ml. But exceeding these thresholds does not automatically imply cancer. Craske explains that there can be other factors such as a recent urinary tract infection which elevate your PSA levels, while some men simply have a larger prostate than average, meaning that their 'normal' level is higher than others. Because of this, statistics show that only one in four men that have a high PSA are at risk of having prostate cancer. What is a normal PSA result? Sooriakumaran says this would be a prostate-specific antigen reading which is within the expected range for your age group. So, for example, for men aged 50-59, this would be below 3.5ng/ml. However again, a 'normal' value can differ from one man to another. 'What really matters is how the PSA changes with time,' says Sooriakumaran. 'Because there's no such thing really as a normal PSA or an abnormal PSA. It's all about how it is for your size of prostate.' I have a normal PSA result. When should I check again? Repeat testing tends to be recommended for men who have an increased risk of prostate cancer due to ethnicity or family history. Some healthcare providers, such as Johns Hopkins Medicine in the US, suggest getting PSA testing done every two to four years to see whether there is any change in the trend, but if your values are low and you have no known risk factors, the NHS may not offer repeat tests. 'If the PSA is completely bang normal, or in the low range, the PSA may not be repeated,' says Sooriakumaran. 'But if you have risk factors, it's up to the GP to decide whether they want to repeat the test one or potentially three years later.' I have a high PSA result. What happens next? If you have a family history of the disease, or you are of black or Ashkenazi Jewish ethnicity meaning that you are of heightened risk, or your PSA levels are particularly high, then your GP will have a discussion about referring you to a specialist for further testing. While some urology specialists may suggest a rectal examination, Sooriakumaran says that more expert urologists will not because it is not a very sensitive or accurate test for prostate cancer. Instead the standard NHS pathway, as recommended by Nice guidelines following a high PSA reading, is a referral for an MRI of the prostate. What further tests can I expect? In some cases, a urine test may be offered to rule out infection as a possible cause of raised PSA levels. But the standard procedure is to then book an MRI of the prostate, followed by a prostate biopsy. Biopsy technology has evolved considerably. Some NHS Trusts still carry out a transrectal prostate biopsy, where an ultrasound probe is inserted through the rectum and used to collect tissue samples from the prostate. However Sooriakumaran says that a newer technology, known as a transperineal biopsy – where a thin biopsy needle is inserted through the layer of perineal skin between the testicles and anus – is becoming more common as it is more accurate and carries a lower risk of infection. 'Over the next year or two, there will be fewer and fewer NHS Trusts that do a transrectal biopsy, and more will move to this newer method,' he says. On the NHS, Sooriakumaran says that the standard timeframe for the results to become available is two to four weeks following the procedure. In the private sector, results will be available between three and seven days. I have a high PSA result, but my GP won't refer me for further tests. What can I do? This could be because while your PSA reading may be outside the expected range for your age, it is still considered only slightly abnormal. In such cases, Sooriakumaran says, it may be standard for a GP to repeat the result a few weeks later, before referring you for further testing. If considered borderline, you may be offered a repeat PSA test six months or a year later, to help assess whether such a result is normal for you or not. How accurate is the test? While the PSA test plays an important role in ensuring that more men are put forward for detailed examinations, the test itself is not especially accurate. According to Cancer Research UK, the major issue is so-called 'false positives' with 75 per cent of men with a high PSA value, not actually having prostate cancer. But there are also 'false negatives' with 15 per cent of men with a normal PSA value actually having the disease. 'This is where the value of the test is greatest when there's repeat measurement over time, so you can see if there's been a change,' says Sooriakumaran. What other factors can raise your PSA levels? As well as age and urinary tract infections, there are a range of factors which can increase your PSA levels in the short term, from inflammation of the prostate, or simply because you have recently been cycling or horse riding. In the latter case, the pressure and movement of the pelvic muscles against the prostate leads to increased blood flow and the release of more PSA into the bloodstream. Even ejaculating or having had sex during the past 48 hours can increase your PSA levels. What are the downsides of the test? One of the major risks is that men with a high PSA test reading have then been referred for an invasive biopsy, which can cause an infection, leading to sepsis. In addition, many men have so-called 'clinically insignificant' prostate cancers, which means that they are very unlikely ever to spread, and so do not require treatment. According to Prostate Cancer UK, new technologies such as next generation multiparametric MRI scans, which are becoming more common, can help to prevent unnecessary biopsies. In addition, newer transperineal prostate biopsies are more accurate at separating the problematic from insignificant cancers, and reducing risk of sepsis. What happens if I'm diagnosed with prostate cancer? You will be referred to a specialist oncologist to discuss the next steps. There are many different paths which can be followed, depending on your circumstances and wishes. If the cancer has not spread beyond the prostate, there are various curative options available ranging from surgery and radiotherapy, to minimally invasive treatments such as so-called focal therapy which involves zapping the tumour with high intensity ultrasound or freezing it. Sooriakumaran says that the biopsy will also reveal whether the cancer is aggressive or low risk. For patients in the latter category, your oncologist may recommend surveillance, especially if they have other conditions like heart disease which pose a greater threat to their life, because the risk of the tumour spreading is low. 'If it has gone outside the prostate, they typically will be offered hormone therapy,' he says. 'If it's just outside the prostate, then they will have radiotherapy as well, and occasionally they might have surgery as well, depending upon how much disease there is outside the prostate.' What are the different treatment options if I have prostate cancer? The good news for men who are diagnosed with prostate cancer is that the range of available treatment options is increasingly broad. Sooriakumaran says that patients have a huge amount of say in what treatment they end up getting, with various advantages and disadvantages to each therapy. Here are some of the options: Focal therapy Therapies such as ultrasound and cryotherapy tend to hold the cancer at bay for a few years rather than curing it, but they have far fewer side effects than other treatment options. Surgery This has the advantage of being a one-off procedure, but cutting a tumour out of the prostate does carry the risk of driving erectile dysfunction or urinary incontinence. Radiotherapy This is a better option for preserving erections, but has more side effects on bowel function, while it tends to involve regular hospital visits across the duration of the treatment course. Hormone therapy Newer hormonal therapies such as abiraterone are only offered for people with metastatic disease which has spread beyond the prostate. They have made a major difference when it comes to slowing down cancer progression and enabling people to live with incurable prostate cancer for much longer, but carry side effects such as hot flushes, reduced libido, weight gain and fatigue. 'It's often up to the patient to decide because some men would rather preserve their erections at all costs, and therefore may not want surgery, while some men don't want to have to come to hospital every day for six weeks,' says Sooriakumaran. 'So it's very much a personal choice, once the specialist has gone through the treatment options.
