We Need to Talk About… Prostate Cancer

In December 2023 our CEO at Six Physio, Rupert Crowfoot, was diagnosed with prostate cancer and told he would need Radical Robotic Prostatectomy surgery. Ru visited Specialist Men’s Health Physiotherapist Lucy Burrows in Parsons Green who provided pre- and post-op advice and worked with him to strengthen his pelvic floor muscles to help try and minimise side effects after the operation. Here Lucy talks about prostate cancer and how Men’s Health Physiotherapists can support people who develop it.

Prostate cancer is the most commonly diagnosed cancer in men, affecting one in eight men in the UK. The chances of developing prostate cancer increase as you get older (past the age of 50), and are higher for black men and those with a family history of the disease.

Some men will live with prostate cancer undetected and it may not cause them any issues at all. However, because men are often symptom free, it’s important to get checked if you have any of the risk factors. Your GP should discuss this with you as you get older but if you are concerned or know you have family members who have developed prostate cancer, you should let your doctor know.

You usually only start to notice symptoms when the prostate has grown to a size that means it is affecting the urethra, which carries urine from the bladder and out of the penis. This can cause urinary problems such as an increased need to go, straining while you pee and feeling like your bladder hasn’t emptied fully.

If you are in one of the higher risk groups or have noticed new symptoms, there are several tests to help determine whether you have prostate cancer, or other common conditions affecting the prostate. These include a blood test called a PSA (prostate-specific antigen) test, a digital rectal examination (physical examination of your prostate), an MRI scan or biopsy.

The UK doesn’t currently have a national screening programme in place for prostate cancer. This is mainly due to the PSA test not always being accurate and sometimes returning a false-positive or false-negative result. You can find out more about the pros and cons of PSA testing on the NHS website here.

Having doctors poke around your private parts is not the nicest experience for anybody, and fear or anxiety around this type of intervention can deter people from going to the doctor and getting checked.

Rupert was prompted to get checked when a friend shared that he had recently had a prostatectomy, and because his brother had also had the same procedure a few years ago. He noticed a drop in energy levels so went to the doctor for a check-up, who advised him to take the PSA test. This returned an elevated score and soon after that Ru was diagnosed with prostate cancer and booked in for surgery.

Ru has recorded a series of videos about his diagnosis, treatment and recovery, to help raise awareness and to encourage men to be more open about talking about their prostate health. You can follow his journey on our Instagram here or watch the videos below.

As CEO of Six Physio, Ru knows a lot of physiotherapists and was aware that physio could help him following his diagnosis, so he booked an appointment with me in Parsons Green.

A Specialist Men’s Health Physiotherapist can provide really important support and treatment to people with prostate cancer. We are experts in this specific area of the body so may be able to provide more targeted advice and information than a general practitioner or urologist. We can also talk you through products that help with side effects post-op, such as the Pacey Cuff for urinary incontinence and penis pump for erectile dysfunction.

We can conduct a real-time ultrasound to show you your pelvic floor and demonstrate different exercises that will help strengthen it. There is strong evidence to suggest that men who practise pelvic floor exercises before surgery will have a better rehab experience afterwards.

It’s really useful to see a physiotherapist both before and after the prostatectomy, so we can measure a baseline of what your pelvic function was like before the operation compared to afterwards, to help track improvement and recovery. We can also treat the wounds around the abdominal area caused by the incision during surgery, for example by providing scar massage.

Ru was acutely aware of how hard people find it to talk about sensitive health issues, which is why he has bravely shared his own personal story, to try and get the message out to more men and encourage more to get tested.

Prostate health has been on the news agenda recently with King Charles’s announcement that he was receiving treatment for an enlarged prostate, followed by an unspecified cancer diagnosis. I hope that this increased public dialogue will ensure more men are aware of the risk factors and more likely to request a PSA test from their GP.

Like with most illnesses, early intervention leads to better outcomes. Raising awareness of prostate cancer and encouraging men to speak to their doctor once they hit 50 should hopefully improve survival rates and mean that more men catch it early.

Part 1: Diagnosis & pre-op

Part 2: Post-op

Part 3: Recovery & reflections

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