London - For the past decade, Ken Hom has undergone an annual private medical MOT - and it is this vigilant approach he credits with saving his life.
“After the age of 50, having a check-up became part of my routine, like visiting the dentist,” says the television chef, whose book accompanying his BBC series Ken Hom’s Chinese Cookery sold a record-breaking 1.2million copies in Britain alone.
“My father died aged 33 of a heart attack, when I was eight months old, so I have always been conscientious - although not obsessive - about my health. I eat red meat only once every two months and have a martini with the same frequency. I have no more than two glasses of wine with a meal, eat lots of vegetables, chicken and fish. I don’t eat sugar or junk food. I’ve never smoked and drink green tea.”
So it came as a shock when, last year, his doctor said there may be a problem with his prostate. Ken, 62, who has homes in France and Thailand, says: “At every check-up I’d always been told I was very healthy. They look at your heart health and do various blood tests. But this time they said my PSA [prostate specific antigen] reading was higher than normal and I should come back in two weeks to have it rechecked.”
The prostate gland - beneath a man’s bladder, wrapped around the urethra - is responsible for the production of seminal fluid. PSA is a protein produced by the cells of the prostate gland, and raised levels can be a sign of a problem, which may be cancer. Normal is four or below. Ken’s was six.
“I wasn’t too worried, but when I was retested the reading had gone up to eight and I needed a biopsy [a surgical procedure in which a sample of tissue is removed from the prostate gland to be examined, determining the severity of the cancer] and a physical examination. It was very painful, and that same day I was told I had a pea-sized tumour in my prostate.”
About 37,000 British men in the UK get prostate cancer each year, with 10,000 dying of it. It is the second-biggest killer of men after lung cancer. Age appears to be the biggest risk factor, with most cases diagnosed over the age of 60. Family history of the disease is also significant.
Most men with early prostate cancer have no symptoms. However, some experience a need to urinate often - especially at night - difficulty starting to urinate and pain during sex. There can also be discomfort in the lower back and blood in the urine, but these symptoms are rare.
Ken was devastated when he was given the diagnosis. “Because of my father, I’d always thought I’d die of a heart attack,” he says. “But, on reflection, I was at risk of cancer: my mother, who was in her late 80s, had just been diagnosed with bowel cancer [in 2009].
“I subsequently learned that my grandparents had died from cancer in their 80s, so it seems I have a genetic predisposition to the disease. It was still very unexpected, as I felt so well. If I hadn’t undergone regular screening, I would never have known.”
Treatment options for prostate cancer vary according to the severity, the age of the patient and what their doctors recommend.
“It depends whether the cancer is localised within the prostate, if it has spread just outside the gland or spread throughout the body,” says Christopher Eden, consultant urologist at the Royal Surrey County Hospital, Guildford.
Surgery, where the prostate is wholly or partly removed, and radiotherapy are the most common methods. Common complications include erectile dysfunction and incontinence.
Other options are active surveillance - regular check-ups and a watch-and-see approach; brachytherapy, where seeds of radioactive material are placed within the tumour to kill the cancer cells; or hormone treatments, where production of testosterone, which causes the tumour to grow, is blocked. Cryotherapy, a technique that freezes the cancer cells, and HIFU (High Intensity Focused Ultrasound), in which the cancer cells are killed by heating them with ultrasound waves, are less common alternative approaches but are suitable if the tumour is small. Ken discussed his treatment options with his doctors in France and Thailand.
He says: “At the same time a Thai friend told me of a businessman who’d had a new kind of treatment in Tokyo for prostate cancer called proton beam therapy, and it had worked.”
Proton beam therapy (PBT), which utilises experimental technology developed by atomic physicists, is similar to radiotherapy in that the patient has radiation directed at the affected tumour site. A particle-beam accelerator delivers high-energy particles, which heat up and destroy the cancer cells. However, unlike conventional radiotherapy, which relies on high-intensity x-ray beams, proton beams can be delivered to the tumour site with far more precision, without damaging surrounding healthy tissue.
“I chose it because I was worried about the side effects of conventional treatments. This promised very few other possible problems,’ says Ken.
After checking that the cancer had not spread, doctors at the Hyogo Ion Beam Medical Centre in Kyoto, Japan, said Ken was suitable for therapy. “My PSA reading was now 12, so I was keen to get on with the treatment,” he says. “As my mother’s cancer had returned, and she was becoming very poorly in Chicago, I felt I had to press ahead with saving my own life.”
Each PBT treatment lasted just two minutes. Ken would arrive at the clinic in the morning, put on a special pair of shorts with holes in them - to help the technicians direct the proton-beam therapy - then lie on a bed. “It was a painless experience,” says Ken. “The only side effects I got were slight sunburn marks on my hips and a tenderness in my bladder when I had to go to the loo, which wore off quickly.”
Two weeks into the treatment, Ken’s mother deteriorated and she died on July 15 in Chicago.
“I was very sad not to be there, but I had to focus on my own chance for health,” he says. His treatment finished by the end of August.
PBT for prostate cancer is not currently available in the UK.
Prostate cancer patients wishing to undergo PBT have to travel abroad: there are clinics in France, Switzerland and Germany, and others in the US and Asia. Roughly 13,000 prostate patients have been treated with PBT in America since 1990.
Consultant urologist professor Roger Kirby, of the Prostate Centre in London, says: “I’ve had some patients go to the US to have this treatment. Some have done well, some haven’t. No one treatment for prostate cancer seems to work for everyone. I will welcome the chance to refer patients to such facilities, but I am sceptical about overly optimistic accounts of how good this is.”
The treatment does appear to have been successful for Ken. “My first check-up in October showed that my PSA was normal. I then had an MRI scan in Paris, which showed no signs of the disease, and in December my PSA level was just over two, so I was ecstatic,” says Ken. “I will have a check-up every three months in Bangkok for the next ten years, but I’m over the moon the treatment has worked and I am quietly confident that I am out of danger.”
Ken credits his healthy-eating regime and exercise of daily swimming with giving him the strength to get through the illness, although he is philosophical about why he got it. “Cancer is genetic, so there is not a lot you can do about it if it does develop. That’s why I think early screening is important.”
Christopher Eden says: “All men over 40 should ask their GP to have an annual PSA test. I hope that with the support of interested parties, we can get a national screening programme active in the UK within a few years. It is a tragedy that many men with the disease in its advanced stages, and for whom there isn’t a good prognosis, would have had treatment a lot earlier if they’d had regular checks.”
Ken considers himself lucky that he could afford the £22,000 needed for the treatment.
He says: “Life is much more precious now. I have wonderful friends, a supportive partner of nearly 40 years, but it has been the concern from strangers that has touched me the most. People who have also gone through cancer have wished me well. It has opened my heart.” - Daily Mail