Mark Jenkins, College Lecturer, heard of the clinical trial that saved him from his tweet.
Actor Stephen Fry had prostate cancer in 2017. He flagged up “an important prostate cancer study” and added: “Do you consider volunteering for this?” This led to Mark signing up.
Mark, who had not yet shown any symptoms, was able to be diagnosed with aggressive cancer thanks to an Imperial College London trial.
He says that he wouldn’t have been here if it wasn’t for that study, which he said two years ago after having surgery that could have saved his life.
Mark Jenkins, a college lecturer, first learned about the clinical trial which saved his life through a tweet by Stephen Fry
Researchers believe that the speedy type of MRI scan that revealed Mark’s tumour could be a reliable method for early detection of aggressive prostate cancers — and lead to a national screening programme for the disease, saving hundreds of lives a year.
Currently the PSA blood test (prostate-specific antibody) is the first step in diagnosing prostate cancer. It’s usually performed at your GP. This test was not intended to be a diagnostic tool. There is also a chance of false positives. About 25% of prostate cancer patients who undergo a biopsy after a PSA increase aren’t diagnosed. Importantly, one in seven prostate cancer victims has normal PSA levels.
Currently, GPs can refer patients who have a high PSA to an MRI scan. The scan takes only 15 minutes, instead of the usual 40. This scan also reveals the warning signs of a prostatic tumour.
In the trial, men were given the short MRI scan – called a Prostagram in a nod to the mammogram for breast cancer – and a PSA test. Prostagram detected aggressive cancers even in low PSA men.
The Prostagram is set to undergo a bigger trial next year. In ten years, researchers expect that the Prostagram can be used to mass screen men 50-70. It is not necessary for them to undergo a PSA testing first.
Mark was 59 when he had the Prostagram in 2019. His PSA score was 1.7. A normal score for Mark’s age group is between 0 to 3.5.
Mark is 56-years old and married to Sandra. They have two daughters. One colleague said, “Next time you purchase a lottery ticket can you give me one?”
Despite the ‘healthy” score, his MRI scan and a biopsy later confirmed that he had a tumor which could have rapidly spread. Radiation would have offered him the best chance of a quick recovery, but it could also lead to side effects such as incontinence and erectile dysfunction. He might have died in a matter of months.
Mark, now at 62 years old, had a much less-invasive procedure to remove his prostate. He still cannot believe his luck today.
Mark is 56-years old and married to Sandra. They have two daughters. “One of my colleagues even suggested that if you ever buy a ticket for the lottery, you could get one for me.” ‘
The length of the scan is the most important part of the Prostagram. David Eldred Evans, a senior researcher and urologist, explained that the Prostagram’s length is crucial for the diagnosis of potentially aggressive prostate cancers.
“There are three sections to the long MRI. The radiologists were asked to examine each section individually, then they were able to compare how precise their diagnoses were with those that they had seen from all the MRI images.
“We realized that one sequence of images was not necessary, as they focus more on the prostate, so we cut the two other ones shorter and made them faster.
“The long MRI could produce 3,000-5,000 images. There are 1000 images in the Prostagram.
Researchers believe that the speedy type of MRI scan that revealed Mark’s tumour could be a reliable method for early detection of aggressive prostate cancers — and lead to a national screening programme for the disease, saving hundreds of lives a year
‘MRI scanners are very mobile and we envisage the same machines you see in hospital being used for mass screening, but in a smaller place — trucks in supermarket or football stadium car parks. The men can get in with their feet first which is great for people who feel claustrophobic.
Professor Hashim Ahmed from Imperial College NHS Trust believes the Prostagram can be used as a basis for a fast, mobile national screening programme to detect prostate cancer. It could also prove to be a game changer.
He stated that men should be able to find aggressive cancers early on, so they can receive less-invasive and side-effect-free treatments.
Dr Eldred-Evans says that because it doesn’t look for low-grade cancers — by the age of 70 to 80, half of all men will have a slow-growing prostate cancer but it will not harm them — the Prostagram is less likely to cause as much over-diagnosis as a PSA test. A study of 408 men published in Jama Oncology showed that a Prostagram detected 75% more aggressive cancers than a PSA test.
“Our study is the first to detect prostate cancer in low-PSA men,” Dr Eldred Evans says. He estimates that the Prostagram could prevent 10 per cent of deaths due to the disease — so saving 1,200 lives a year.
Dr Eldred Evans believes men should continue to be encouraged by a PSA screening. However, he points out that the PSA test was created as a way for prostate cancer detection and monitoring, not diagnosis. Prostagram screening would also eliminate the need to have a rectal examination performed by a physician.
Mark seemed otherwise healthy. In 2014, however, Mark experienced problems urinating. This can indicate an infection or an enlarged prostate.
He said, “It was getting harder to empty the bladder. My PSA score was very low. Although it was bothersome, the problem with my urinary tract could be managed.
Mark had already seen Fry’s November 2018 tweet and was aware of the issue.
He had been a Cranfield University professor of Management and enjoyed helping other academics in their research. Mark was able to travel from Ampthill (Bedfordshire) to London with his Prostagram.
A week later, he was phoned to come in for a biopsy — at the time, he didn’t realise this was not part of the trial and ‘it didn’t set alarm bells ringing’.
Three weeks later, he went alone to Charing Cross Hospital for the results — to be told he had cancer. He says that although it didn’t grow beyond the prostate, it did spread to other parts of his body. “I was unable to absorb the information and asked him if I could record it.
He was offered various options including cryotherapy — killing the cancer cells by freezing them — but chose to have surgery.
He said, “I wanted to get rid of the cancer.” “I had just celebrated my 60th birthday, and Sandra and me had planned to travel to Alaska for three week. The surgeon told me he would go on vacation and then have surgery.
Dr Eldred Evans states that Prostagram is a pro-active treatment option, which allows for early diagnosis and can have fewer side effects. “Another benefit is the reduction in unnecessary surgery for benign tumours that pose no risk.
It is possible for a man to be told that he has prostate cancer.
Ten years ago we had removed most of the cancers. Now we can only treat 10%.
The next step is a £2 million Prostagram trial of 20,000 men.
Mark has to take a PSA test once every six months. Because it is useful for following up on patients who have been treated, Mark was happy to take the PSA test.
Mark took his retirement last year, and now plans to travel more with Sandra. He says, “Our philosophy was always about moving on,” “Life is precious, and you never know what the future holds. So make the best of your time.
For information on the next Prostagram trial, visit: imperial.nhs.uk/prostagram. To help fund it, go to: imperial.ac.uk/giving/donate/prostagram