“Prostate screening is pivotal. Without it, a lot of guys are going to be stuffed.”

Over six years ago, hair and scalp consultant Russell McFarlane went to see his GP after hearing that men of Afro-Caribbean ethnicity were more likely to get prostate cancer.

“Us men, we’re not very good at coming forward when it comes to health. We think it’ll be alright. We’ll get on with it. But this felt important,” the 64-year-old from Sheffield explains. 

Being half Jamaican and half British, Russell told his GP that because of his dual ethnicity, he wanted to be checked. However, he was turned away and told to return when he had symptoms.

“It was bizarre,” Russell remembers. “I was bemused because I wondered, at what stage do symptoms kick in and at what stage do I need to notify the doctor? At what point does a guy think, this isn’t normal? When you go for a wee, has it been taking longer? Has it been uncomfortable? These are things you live with and you’re not always aware of them. On the face of it, there was nothing to indicate that anything adverse was happening.”

In June 2023, it was brought to Russell’s attention that 1 in 4 Black men will get prostate cancer at some point in their lives. This stark statistic gave him another push to ask about being checked.

This time, Russell’s GP carried out an examination of his prostate and told him that it was enlarged. An enlarged prostate is often linked to the ageing process, but the doctor said she would refer Russell for a ‘prostate specific antigen’ (PSA) test, which measures the amount of a protein called PSA in the blood.

A raised PSA level can indicate a problem with the prostate. However, another 14 months went by before Russell finally had the test.

“I just thought they were busy,” Russell says. “I didn’t want to seem too anxious. It’s worrying because it felt like the onus was on me to make sure I got a test booked. I could have left it indefinitely, and that could have been fatal for me. My girlfriend Helen encouraged me to call them up, and so I finally got it sorted.”

The results of the test showed that Russell’s PSA level was raised. Men aged 50 or over can ask their GP for a free PSA test, however the test is not routinely offered through the NHS because it is not considered a reliable way of screening for cancer in people without symptoms. It is possible to have a raised PSA level and not have cancer, and it is possible to have cancer without a raised PSA level. Because of this, GPs can be reluctant to offer tests when men don’t have any symptoms.

Unfortunately, further scans and tests confirmed that Russell did have prostate cancer.

Russell received his diagnosis just before Christmas 2024, and he has since been considering treatment options including ‘brachytherapy’. This involves placing small radioactive seeds into the prostate which slowly release radiation to kill the cancer cells. 

Having a large family and his own business to run, Russell is keen to avoid any treatment that might adversely affect his day-to-day life.

He says: “I have to make myself available as best I can because I’ve got nobody else to rely on to do the work I do. We’ve also got four children between us, two grandchildren and another grandchild on the way. As well as the family being very important, my business plays a huge part in my life, so it’s a case of having what is going to be the least intrusive and least invasive treatment for me.

 “I will have a further appointment to confirm my options, but the brachytherapy seems the best one for me. It’s precise and targeted on the prostate, killing off fewer good cells and with minimum side effects. Had my cancer progressed more, I might not have been able to have this treatment. If I’d not pushed to be tested, in a few years’ time, things could have been very different.”

Russell is being looked after by James Catto, Professor of Urology at the University of Sheffield and an Honorary Consultant Urological Surgeon at Sheffield Teaching Hospitals NHS Trust. Professor Catto is leading a new prostate screening trial called IMProVE, which is funded by Yorkshire Cancer Research.

The trial is investigating how a national screening programme for prostate cancer could be introduced so that men at risk of developing the disease, who don’t have symptoms, are automatically invited for testing without having to ask.

“Jim said to me I’ve probably had this cancer for five or 10 years based on their studies and the size of the mass. I’ve always tried to look after myself and I feel great. But it just shows that you can keep yourself looking good on the outside, but you don’t always know what’s happening on the inside. That’s been a real wake-up call. 

“It’s something you’ve got no control over, but the sooner you can get diagnosed with it, the more options you have. If men are able to be screened for it, it will either eliminate any worry or make men aware that there is something happening that needs to be addressed.”