Targeted prostate cancer screening could save thousands of Jewish lives

In my day job, I often tell people what to do and what not to do – hopefully as gently as possible, but still very definitely: love your neighbour as yourself… observe the Sabbath. Not just religious advice but often practical too: make a will if you have not done so…don’t avoid medical check-ups. I try to keep people happy and healthy. 

But I fell into the trap of giving advice but not following it myself. One day, a friend challenged me and asked if I’d had a PSA blood test, the first test to check for signs of prostate cancer. I thought it was a waste of time, but I also thought I ought to show willingness, and so I went to my doctor. I was shocked to learn that I not only had prostate cancer but that it was a highly aggressive type and was advanced.

My cancer needed a full removal of my prostate, and the big risk was that it might have already spread to the rest of my body. I was lucky, and it was caught just before it would have spread further.

Get The Jewish News Daily Edition by email and never miss our top stories Free Sign Up

For me, the most astonishing aspect was that there had been no symptoms and no discomfort whatsoever. My friend’s chance remark (and, to give me credit, my quick response) saved my life. Had he and I not met up for another few weeks, it might have been too late.

I am still telling people what to do and what not to do, but with more personal conviction than before, while I am particularly explicit about prostate cancer, both because it is so prevalent and because it is so easy to stop if detected early. If prostate cancer is caught early on, it need not lead to major surgery or to a terminal diagnosis. Everything hinges on those two crucial words: early detection.

1 in 8 men will get prostate cancer. It’s the most common cancer in men and affects so many dads, sons, partners and friends around the UK. In its early stages, prostate cancer often doesn’t have symptoms, as was my case. The earlier you find prostate cancer, the easier it is to treat, but until now there has been no screening of any kind for the disease, meaning the responsibility to know you are at risk and act on this knowledge has rested entirely on men’s shoulders.

In November, the UK National Screening Committee announced that it was not recommending mass screening based on the current evidence, but it has now recommended a programme for men who have BRCA gene variations and are therefore at much higher risk of the disease.

I know there will be men and their families who will have been disappointed by the Committee’s decision, who feel this decision has continued to leave them and their loved ones’ lives to chance, and my thoughts are with those men. But change must start somewhere, and beginning with the men whose very genetic makeup means they are at higher risk of this cancer is a sensible, scientific approach we should all endorse.

BRCA genes work to keep healthy cells growing normally and prevent the growth of cancer cells. Many people are aware that BRCA gene changes are associated with increased risk of breast cancer, but they are also associated with prostate cancer. Latest research from the Institute of Cancer Research shows that men with BRCA1 and BRCA2 gene variants are at higher risk of more aggressive prostate cancer at a younger age than other men.

In the general population, around 1 in 300 to 400 people have a BRCA gene variant. However, people from an Ashkenazi Jewish background have a higher risk – around 1 in 40 people may carry a BRCA gene variant. Prostate cancer screening for men with BRCA gene variations will give tens of thousands of men their best chance of finding prostate cancer early, many of them Jewish men.

This decision has been years in the making and is driven by cutting-edge research. Professor Ros Eeles from the Institute of Cancer Research discovered that BRCA2 variations were associated with a higher risk of prostate cancer in 2017, through research funded by Prostate Cancer UK.

The decision in November was the first time the National Screening Committee has recommended prostate cancer screening in any form, so it’s clear that evidence has the potential to shift the dial and one day unlock prostate cancer screening for all men. Prostate Cancer UK’s £42 million TRANSFORM clinical trial will generate that evidence. The trial is underway now, with Professor Eeles as one of its leads, and we should start to see results in just two years.

And although the NSC has recommended screening for men with a BRCA gene variant, this will take some time to implement. But there are things men can do now.

The NHS Cancer Programme and the NHS Genomics Programme are currently working together to establish new arrangements for a BRCA testing programme for those of Jewish ancestry. Anyone with one Jewish grandparent can register for testing here: https://nhsjewishbrcaprogramme.org.uk/.

If you already know you have the gene variant and you’re worried about prostate cancer, you can speak to your GP about the option to have a free and simple PSA blood test, which is the first test to check for prostate cancer. You can also find out more about your risk and the PSA blood test with Prostate Cancer UK’s online Risk Checker, which can tell you if you’re at higher risk of prostate cancer and what you can do about it.

Prostate cancer is curable if found early, and targeted screening for men with the BRCA gene variation will save more lives. It’s about time we unlocked the future of screening for all men.

• Rabbi Dr Jonathan Romain MBE is a writer and broadcaster, and convenor of Progressive Judaism’s Reform Beit Din.