Thousands of men are to be checked for prostate cancer in one of the first large-scale European trials of smart screening.
The pilot study, starting next week in Ireland, will combine a blood test with personal risk factors and an MRI scan to increase the accuracy of screening men in their 50s and 60s.
Up to now health experts have rejected population screening in the belief that the benefits of earlier cancer detection were outweighed by the risks that some men could have unnecessary biopsies and risky treatment they don’t need.
But the PRAISE-U study is an attempt to save lives in a more targeted way, filtering out men who don’t have cancer at an early stage, so they don’t come to any harm.
David Galvin, the head of the study and a surgeon at the Mater Hospital in Dublin, told Sky News that a safe, effective screening strategy was urgently needed.
“There is a tsunami of elderly patients coming towards us,” he said.
“There’s going to be a sharp rise in prostate cancer unless we have a way to detect the disease early and not burden our health care services with vast numbers of scans and biopsies.”
Image: David Galvin, consultant urologist at The Mater Hospital in Dublin
Thousands diagnosed too late
Prostate cancer is the most common cancer in men in Ireland. In the UK it is now the most common of all cancers, causing more deaths than breast cancer.
There are no symptoms in the early stages. Around 12,000 men a year in the UK alone are diagnosed too late to cure.
Studies have shown that a blood test for a prostate protein called PSA can diagnose cases at an earlier stage, reducing deaths by 40%.
But not all men with cancer have high levels of the PSA protein.
And conversely, high levels can also be caused by other prostate conditions, infections, exercise and sexual activity.
Image: An example of a prostate tumour seen on a MRI scan
The unreliability of the test has held back its use for screening.
But in the Irish pilot study, men will be scored by their PSA level and whether they have other risk factors such as black ethnicity or a family history.
Those at low risk will be retested in future.
Around half of the men will undergo a detailed MRI scan of their prostate to check for tumours – and only half those will then need a biopsy, in which a needle is inserted to extract cells for a precise diagnosis.
Professor Galvin said the multi-stage screening meant only those who really need a biopsy will have one.
“I worked out that if you have the PSA test, there’s about a 1 in 40 chance that you will ultimately need a biopsy.
“The other 39 men are reassured that testing is all normal and they don’t have any clinically significant disease.”
The PRAISE-U study is backed by the European Association of Urology and funded by the EU.
Around 8,000 men in Waterford and two areas of Dublin will be randomly invited for screening over the next year.
Tony Ward, a rugby legend and one of the best number 10s to play for Ireland, was diagnosed with an aggressive prostate cancer just over a decade ago. Even now he needs daily treatment and regular scans.
He told Sky News screening to detect cancer at an earlier stage is desperately needed.
“It’s everything, it’s massive,” he said.
“I did not have the early diagnosis, but I got away with it by the skin of my teeth.”
Image: Thomas Moore speaking to Tony Ward
‘Very curable cancer kills 12,000 men every year’
The UK’s National Screening Committee, which advises the Department of Health, is reviewing the evidence on prostate cancer screening. But it’s already taken two years, and a decision still isn’t due until the end of 2025.
Chiara De Biase, director of health services, equity and improvement from Prostate Cancer UK, said men were dying unnecessarily as a result.
She said: “12,000 men die every year from what is – when caught in its earliest stages – a very, very curable cancer.
“We think the evidence [for screening] is there and we can’t see why this has taken so long.”
Image: Chiara De Biase, director of health services, equity & improvement from Prostate Cancer UK
A spokesperson for the UK government’s Department of Health and Social Care said: “Prostate cancer patients are waiting too long for diagnosis and treatment, and we are determined to change that.
“Our National Cancer Plan will transform the way we treat cancer, making the UK a world leader in cancer survival by fighting the disease on all fronts, through improving research, diagnosis, screening, treatment and prevention.
“The UK National Screening Committee is reviewing the evidence for prostate cancer screening programmes, including targeted approaches for men at higher risk.”
A care worker who reported the alleged abuse of an elderly care home resident, which triggered a criminal investigation, is facing destitution and potential removal from Britain after speaking up.
“Meera”, whose name we have changed to protect her identity, said she witnessed an elderly male resident being punched several times in the back by a carer at the home where she worked.
Sky News is unable to name the care home for legal reasons because of the ongoing police investigation.
“I was [a] whistleblower there,” said Meera, who came to the UK from India last year to work at the home.
“Instead of addressing things, they fired me… I told them everything and they made me feel like I am criminal. I am not criminal, I am saving lives,” she added.
Image: ‘Meera’ spoke up about abuse she said she witnessed in the care home where she worked
Like thousands of foreign care workers, Meera’s employer sponsored her visa. Unless she can find another sponsor, she now faces the prospect of removal from the country.
“I am in trouble right now and no one is trying to help me,” she said.
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Meera said she reported the alleged abuse to her bosses, but was called to a meeting with a manager and told to “change your statement, otherwise we will dismiss you”.
She refused. The following month, she was sacked.
The care home claimed she failed to perform to the required standard in the job.
She went to the police to report the alleged abuse and since then, a number of people from the care home have been arrested. They remain under investigation.
‘Migrants recruited because many are too afraid to speak out’
The home has capacity for over 60 residents. It is unclear if the care home residents or their relatives know about the police investigation or claim of physical abuse.
Since the arrests, the regulator, the Care Quality Commission (CQC), carried out an investigation at the home triggered by the concerns – but the home retained its ‘good’ rating.
Meera has had no reassurance from the authorities that she will be allowed to remain in Britain.
In order to stay, she’ll need to find another care home to sponsor her which she believes will be impossible without references from her previous employer.
She warned families: “I just want to know people in care homes like these… your person, your father, your parents, is not safe.”
She claimed some care homes have preferred to recruit migrants because many are too afraid to speak out.
“You hire local staff, they know the legal rights,” she said. “They can complain, they can work anywhere… they can raise [their] voice,” she said.
Image: Sky’s Becky Johnson spoke to ‘Meera’
Sky News has reported widespread exploitation of care visas and migrant care workers.
Currently migrants make up around a third of the adult social care workforce, with the majority here on visas that are sponsored by their employers.
As part of measures announced in April in the government’s immigration white paper, the care visa route will be closed, meaning care homes will no longer be able to recruit abroad.
‘Whole system is based on power imbalance’
But the chief executive of the Work Rights Centre, a charity that helps migrants with employment issues, is warning that little will change for the tens of thousands of foreign care workers already here.
“The whole system is based on power imbalance and the government announcement doesn’t change that,” Dr Dora-Olivia Vicol told Sky News.
She linked the conditions for workers to poor care for residents.
Image: Work Rights Centre CEO Dr Dora-Olivia Vicol
“I think the power that employers have over migrant workers’ visas really makes a terrible contribution to the quality of care,” she said.
Imran agrees. He came to the UK from Bangladesh, sponsored by a care company unrelated to the one Meera worked for. He says he frequently had to work 14-hour shifts with no break because there weren’t enough staff. He too believes vulnerable people are being put at risk by the working conditions of their carers.
Migrant workers ‘threatened’ over visas
“For four clients, there is [a] minimum requirement for two or three staff. I was doing [it] alone,” he said, in broken English.
“When I try to speak, they just directly threaten me about my visa,” he said.
“I knew two or three of my colleagues, they are facing the same issue like me. But they’re still afraid to speak up because of the visa.”
A government spokesperson called what happened to Imran and Meera “shocking”.
“No one should go to work in fear of their employer, and all employees have a right to speak up if they witness poor practice and care.”
James Bullion, from the CQC, told Sky News it acts on intelligence passed to it to ensure people stay safe in care settings.
Donald Trump may be denied the honour of addressing parliament on his state visit to the UK later this year, with no formal request yet submitted for him to be given that privilege.
Sky News has been told the Speaker of the House of Commons, Sir Lindsay Hoyle, hasn’t so far received a request to invite the US president to speak in parliament when he is expected to visit in September.
It was confirmed to MPs who have raised concerns about the US president being allowed to address both houses.
Kate Osborne, Labour MP for Jarrow and Gateshead East, wrote to the speaker in April asking him to stop Mr Trump from addressing parliament, and tabled an early-day motion outlining her concerns.
“I was happy to see Macron here but feel very differently about Trump,” she said.
“Trump has made some very uncomfortable and worrying comments around the UK government, democracy, the Middle East, particularly around equalities and, of course, Ukraine.
“So, I think there are many reasons why, when we’re looking at a state visit, we should be looking at why they’re being afforded that privilege. Because, of course, it is a privilege for somebody to come and address both of the houses.”
But the timing of the visit may mean that any diplomatic sensitivities, or perceptions of a snub, could be avoided.
Image: France’s President Emmanuel Macron addressed parliament during his state visit this month
Lord Ricketts, a former UK ambassador to France, pointed out that parliament isn’t sitting for much of September, and that could help resolve the issue.
In 2017, he wrote a public letter questioning the decision to give Donald Trump his first state visit, saying it put Queen Elizabeth II in a “very difficult position”.
Parliament rises from 16 September until 13 October due to party conferences.
The dates for the state visit haven’t yet been confirmed by Buckingham Palace or the government.
However, they have not denied that it will take place in September, after Mr Trump appeared to confirm they were planning to hold the state visit that month. The palace confirmed this week that the formal planning for his arrival had begun.
With the King likely to still be in Scotland in early September for events such as the Braemar Gathering, and the anniversary of his accession and the death of Queen Elizabeth on the 8th September, it may be expected that the visit would take place sometime from mid to the end of September, also taking into consideration the dates of the Labour Party conference starting on the 28th September and possibly the Lib Dem’s conference from the 20th-23rd.
Image: Mr Trump has said he believes the trip to the UK will take place in September. Pic: Reuters
When asked about parliamentary recess potentially solving the issue, Ms Osborne said: “It may be a way of dealing with it in a very diplomatic way… I don’t know how much control we have over Trump’s diary.
“But if we can manoeuvre it in a way that means that the House isn’t sitting, then that seems like a good solution, maybe not perfect, because I’d actually like him to know that he’s not welcome.”
A message from the speaker’s office, seen by Sky News, says: “Formal addresses to both Houses of Parliament are not automatically included in the itinerary of such a state visit.
“Whether a foreign head of state addresses parliament, during a state visit or otherwise, is part of the planning decisions.”
Image: Mr Trump made his first state visit to the UK in June 2019 during his first presidency. File pic: Reuters
It’s understood that if the government agrees to a joint address to parliament, the Lord Chamberlain’s office writes to the two speakers, on behalf of the King, to ask them to host this.
It will be Mr Trump’s second state visit.
During his first, in 2019, he didn’t address parliament, despite the fact that his predecessor, Barack Obama, was asked to do so.
It was unclear if this was due to the fact John Bercow, the speaker at the time, made it clear he wasn’t welcome to do so.
However, it didn’t appear to dampen Mr Trump’s excitement about his time with the Royal Family.
Speaking earlier this year, he described his state visit as “a fest” adding “it’s an honour… I’m a friend of Charles, I have great respect for King Charles and the family, William; we have really just a great respect for the family. And I think they’re setting a date for September.”
It is expected that, like Mr Macron, the pageantry for his trip this time will revolve around Windsor, with refurbishment taking place at Buckingham Palace.
Liverpool have retired the number 20 shirt in honour of Diogo Jota – the first time it has made such a gesture.
The club said it was a “unique tribute to a uniquely wonderful person” and the decision was made in consultation with his wife and family.
The number 20 will be retired at all levels, including the men’s and women’s first teams and academy squads.
A statement said: “It was the number he wore with pride and distinction, leading us to countless victories in the process – and Diogo Jota will forever be Liverpool Football Club’s number 20.”
The club called it a “recognition of not only the immeasurable contribution our lad from Portugal made to the Reds’ on-pitch successes over the last five years, but also the profound personal impact he had on his teammates, colleagues and supporters and the everlasting connections he built with them”.
Image: Jota’s wife joined Liverpool players to view tributes at Anfield on Friday. Pic: Liverpool FC
Image: Pic: Liverpool FC
Newly-married Jota died alongside his brother when his Lamborghini crashed in northern Spain on 3 July.