**Pensioner’s Experience Prompts Renewed Calls for Change in Prostate Cancer Testing**
A 70-year-old man from Abergele, Conwy, is calling for a national rethink on prostate cancer screening procedures after a widely used examination failed to detect his cancer, forcing him to pay nearly £900 for a scan that ultimately saved his life.
Raymond Starr, a retired civil servant, first became aware of potential health concerns in 2014, when a routine visit to his GP flagged a slightly raised PSA (prostate-specific antigen) level. Over the following years, as his PSA readings continued to climb, Raymond underwent the traditional diagnostic pathway, including rectal examinations and tissue biopsies. However, these standard procedures failed to uncover his prostate cancer.
It was not until 2017, driven by growing uncertainty, that Raymond pursued a more advanced investigation. Despite his GP’s advice, he was told the NHS did not have a multiparametric MRI (mpMRI) scanner available in north Wales. Faced with limited options, Raymond paid £890 for a private mpMRI scan—a decision that proved crucial. The scan identified his cancer, and an operation to remove his prostate gland later cleared him of the disease.
Reflecting on his experience, Raymond expressed concern: “If it hadn’t been for the mpMRI scan, I could have continued living, completely unaware of the danger I was in. The initial tests didn’t find my cancer, and I might have missed the window for treatment.” Now enjoying good health after surgery, he added, “I’ve been able to live life fully, even getting married recently. It’s important more men know that you don’t always need a ‘finger up the bum’ to be checked for prostate cancer—a simple blood test should be the starting point.”
Raymond’s campaign with Prostate Cancer UK helped ensure that mpMRI scans are now available on the NHS across Wales. Yet, his advocacy has taken on a fresh urgency following a recent statement from the British Association of Urological Surgeons (BAUS). Both BAUS and Prostate Cancer UK are now urging the NHS to phase out routine use of the digital rectal examination (DRE), citing its limited effectiveness and the stigma it carries.
Despite these recommendations, the rectal exam continues to be widespread in GP surgeries. A recent Prostate Cancer UK survey found that one in three men who requested a PSA blood test were also offered a rectal exam, while a small but significant percentage were offered the rectal exam in place of the blood test. This persistence has raised questions about whether current NHS guidelines—which still recommend the rectal examination for men with symptoms—are keeping up with the latest clinical evidence.
For many men, the association of prostate cancer with the so-called ‘finger test’ acts as a psychological barrier to seeking medical advice. “Men are often too embarrassed to talk about the disease, which can delay vital diagnoses,” a spokesperson for Prostate Cancer UK commented. The charity, backed by the new stance from BAUS, maintains that a PSA blood test should become the primary means of screening, with the rectal examination reserved for select cases where necessary.
It is important to note that men over 50, black men over 45, or those with a family history of prostate cancer are at increased risk and are encouraged to request a free PSA blood test from their GP, according to Prostate Cancer UK. The charity estimates that one in eight men in the UK will develop prostate cancer in their lifetime.
The Royal College of GPs has taken a more cautious approach, stating that while emerging evidence should shape policy, any major shift away from current protocols should be based solidly on research to maintain clinical safety and best practice.
As the debate over screening methods intensifies, the Welsh Government has been approached for comment regarding the ongoing reliance on the rectal exam and the need for guideline updates.
Raymond’s message is clear: “The fear and stigma around the rectal exam are still stopping men from getting checked. But what’s most important is early, accurate detection—something a simple blood test can help achieve. I hope sharing my story encourages men to prioritise their health and push for better testing across the board.”