Are men still reluctant to talk about prostate cancer?
In a bid to prevent the number of deaths from prostate cancer rising, one initiative was developed to get males to talk more on the subject
Prostate cancer in males has overtaken breast cancer in the number of deaths, according to new research. One initiative, developed by advanced nurse practitioner Sarah Minns, hopes to drive awareness of earlier diagnosis – in a bid to prevent rising numbers.
Prostate cancer is the most common cancer among males in the UK. Approximately one in eight will develop the disease in their lifetime. Figures for 2015, released by Prostate Cancer UK in February 2018, show the number of men dying from prostate cancer has now overtaken female deaths from breast cancer for the first time.
Although early diagnosis greatly improves the prognosis, there is currently no national screening programme for prostate cancer. Men are often slow to talk to their GP if they have symptoms: some may feel scared or embarrassed, while others find it hard to fit an appointment into their busy schedules.
Advanced nurse practitioner Sarah Minns, of Burton Hospitals NHS Foundation Trust, has worked in urology for 27 years. In 2015 she and consultant urological surgeon Jyoti Shah decided to raise awareness of prostate cancer in the community, launching their Inspire Health: Fighting Prostate Cancer campaign.
The idea behind their campaign was to reach out to men in an environment where they felt comfortable – and therefore encourage them to attend for screening.
Having visited the local football club, Burton Albion, to promote men’s health and prostate screening, they set up a pop-up screening clinic for men over the age of 50 at the Pirelli Stadium in Burton-upon-Trent.
The first two-day clinic was held in March 2016 and 113 men attended – a great success and the culmination of several challenging months of preparation.
Prostate cancer – the facts
- Prostate cancer is the most common cancer among men in the UK, with approximately one in eight being diagnosed at some point
- Black males are more at risk, with about one in four being diagnosed during their lifetime
- Prostate cancer mainly affects men over the age of 50, and the risk increases with age
- 11,819 men die from prostate cancer every year in the UK, compared with 11,442 women who die from breast cancer
To get the clinic up and running Ms Minns and Miss Shah had to convince people their idea was worthwhile. They collaborated with the football club, approached the local Round Table and Rotary Clubs for funding, and had several meetings with the editor of the local newspaper for publicity.
They also negotiated with the local Clinical Commissioning Groups (CCGs). Miss Shah explains: ‘We needed to get the CCGs on board because we wanted the men attending the screening to stay with us throughout the entire treatment process.’
Usually men who attend a pop-up clinic receive a letter with their result and are referred back to their GP – who will then refer them to a urologist if necessary. This means there can be a significant delay in diagnosing cancer.
If men who attend the Burton Albion screening clinic need further investigating, they see the same team for a prostate biopsy just a few days later. Those with cancer are often diagnosed within a fortnight. They have all their follow-up investigations and treatment with the team.
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Ms Minns plays a vital role in ensuring this continuity of care. She explains: ‘The men see me all the way through their journey, from when they first attend for assessment to the time of their diagnosis. They all have my contact number and are able to call for support.’
She holds a counselling diploma and has completed advanced communication training courses. These skills help her ensure the men understand the investigations they are having and feel supported.
Men are encouraged to pre-book a 10 minute slot at the two-day screening clinics. This means Ms Minns can check their NHS details and print blood sample labels in advance, to minimise any errors.
During the clinic she is responsible for carrying out the prostate-specific antigen (PSA) blood tests and then taking the samples to the laboratory.
The local press has been supportive of the initiative. The Burton Mail has featured many men’s personal stories, and Ms Minns was present during the interview process, ‘in case they needed any moral support while discussing their cancer journey.’
Word of the project spread so quickly that it has been covered by BBC West Midlands News, and featured on the BBC’s One Show.
As the profile of the clinics has grown, Ms Minns and Miss Shah have begun reaching out to specific groups such as the African-Caribbean community. Black men are twice as likely to develop prostate cancer as white men.
The Derbyshire Freemasons also heard about the clinics, and are now working with the team to offer screening to their communities.
Almost 750 men have attended screening clinics organised by Ms Minns and Ms Shah, and 36 have been diagnosed with prostate cancer.
The team collects feedback at each event, and over 95% of attendees have said they are extremely satisfied with the service.
One of the first men diagnosed with cancer by the team had attended the football stadium as a steward, but thought he ‘might as well take the opportunity to be screened’ while he was there.
More than 47,000
men are diagnosed with prostate cancer every year
He said: ‘From the moment I walked into the clinic and ever since, I have been cared for as if I was the only man in the world with prostate cancer.’
Ms Minns and Miss Shah hope the success of their project will inspire other medical teams to take health promotion out into their local communities.
Miss Shah emphasises that the initiative goes beyond prostate screening – it is also an opportunity to encourage men to think about their health more generally: ‘For example, if they smoke we ask them if they’ve thought about stopping.’
Sarah Minns’ advice for nurses keen to start a community project
- Be open-minded – it’s important to understand and communicate with the groups you are targeting.
- Make sure you have a colleague on board who is able to support you.
- Think about what screening venues would work in your local area, or for the groups you are targeting. In Burton-on-Trent the football stadium was an ideal solution, but this would not be suitable in every location.
Ms Minns’s dedication has been vital to the campaign’s success. Miss Shah says: ‘All the screening and follow-up work is carried out in our own time, on top of our regular NHS work. Sarah has never taken any of this time back.’
This commitment has resulted in Ms Minns being shortlisted for several awards, including the RCNi Community Nursing Award in 2017. She says she was ‘extremely proud to be nominated and shortlisted – it was a great honour.’
She adds that her good relationship with consultant Miss Shah is all-important: ‘We worked closely together before embarking on this project, and we each have our own areas of expertise. We have a great deal of mutual respect, which is vital when you spend so much time working with someone.’
Reflecting on her personal experience of the work, Ms Minns says she enjoys meeting people in the various community settings. She adds: ‘I get a lot of job satisfaction out of raising awareness of prostate cancer. Ultimately we are saving lives, and it is very rewarding to know that.’