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My cancer was missed by infamous test then I had to pay £890 for life-saving scan
My cancer was missed by infamous test then I had to pay £890 for life-saving scan
'I could have been walking around totally blind to the danger that I was in'
Raymond Starr was diagnosed with prostate cancer after years of uncertainty
A pensioner had to fork out £890 for a life-saving scan after his prostate cancer was missed by a rectal exam.
Raymond Starr, a 70-year-old from Abergele in Conwy county, was found to have a slightly elevated PSA – prostate-specific antigen – level in 2014 during a routine medical at his GP surgery. As his levels continued to rise Raymond underwent a rectal exam and biopsies which failed to detect his cancer. It was not until July 2017 that he received a diagnosis – and only after he had paid for a multiparametric MRI (mpMRI) scan.
Despite a recommendation from Raymond's GP he had to pay £890 for an mpMRI because no scanners were available on the NHS in north Wales.
"Thankfully my cancer was caught before it had a chance to spread to other parts of my body," said the retired civil servant, who is cancer-free following the removal of his prostate gland. "But if it wasn't for the mpMRI I could have been walking around totally blind to the danger that I was in after the other tests didn't catch my cancer."
Raymond successfully campaigned with the Prostate Cancer UK charity for mpMRI scans to be made accessible across the NHS in Wales but he is now sharing his story to call for another change.
He is backing Prostate Cancer UK's message that the first test for prostate cancer should be a simple blood test rather than a rectal exam. It comes after the British Association of Urological Surgeons made the landmark decision to join the charity in calling for an end to the routine use of the rectal exam, which they have branded a 'poor test'.
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A Prostate Cancer UK spokeswoman said: "Alarmingly, despite the rectal exam's poor ability to detect cancer, new data shows it's still being offered to men.
"In a recent survey of men who had completed Prostate Cancer UK's risk checker around 750 men said they'd asked their GP for a PSA blood test. A third of these men were offered a rectal examination as well as a PSA blood test. Concerningly 3% of men were offered a rectal exam instead of a PSA blood test.
"The infamous 'finger' test has long been associated with prostate cancer and stigma around it makes lots of men feel too scared or embarrassed to talk to their GP about the disease."
The British Association of Urological Surgeons says guidelines for GPs – which have not been updated since 2016 – must be changed to reflect that the blood test is superior and that digital rectal exams (DREs) are "no longer necessary". The current guidelines recommend that men with symptoms have a DRE and a PSA blood test.
It's important to note that men aged 50 or over can ask their GP for a PSA blood test even if they do not have symptoms.
The Royal College of GPs says it is vital to use the most evidence-based methods but that it is 'sensible to wait for the evidence to become available before we change current clinical practice and move away from DRE altogether'.
Raymond added that he has been "doing well" since his prostatectomy. "I've been living life to the full and got married to my partner. I'm positive about the future and I'm passionate about raising awareness of this disease.
"Fear of having a 'finger up the bum' is still putting people off when actually you don't need to have it and it's not a good test. That's why this movement is so vital to get the message out that you don't need a rectal exam to test for prostate cancer – it's just a simple blood test."
According to Prostate Cancer UK one in eight men will get this type of cancer. If you're over 50, a Black man over 45, or you've got a family history of prostate cancer you're at higher risk of getting the disease so should think about getting a free blood test from your GP, says the charity.
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The Welsh Government has been approached for comment on the concerns over the rectal exam.
