1. „My instinct was to deal with the
cancer as soon as possible‟
Sir Martin Narey’s PSA score went from 4.5 to 10.5 before he decided to seek treatment David Bebber,
The Times
Martin Narey
Published at 12:01AM, December 4 2013
A year ago, as I lifted a large Christmas tree into place in our front garden, I was
feeling very content with life. Both our children and their partners were planning
to join us at Christmas, along with members of my own large extended family. My
wife, Jan, had just had confirmation that she had obtained her PhD and I had just
been told that I was to be knighted in the New Year‟s Honours List.
Life seemed unusually good. Then the phone rang and I was asked if I could drop
into my GP surgery that afternoon.I‟m rarely at my doctor‟s. I‟m one of those
lucky people who don‟t get flu or serious colds and I‟m rarely unwell. I worked for
almost 25 years in the Civil Service before taking my first day‟s sick leave. Almost
because of that, a few weeks earlier I‟d had a series of “well man” tests.One of

2. those, a measure of my prostate-specific antigen (PSA), had returned a little high.
I already knew a little about the test and its use as an indicator of prostate cancer.
I was also aware that I was in a high-risk group for that disease, as both my
parents died from cancer, two sisters had battled breast cancer — sadly, only one
of them successfully — and my eldest brother, John, had been managing prostate
cancer for more than ten years.
My PSA score was 4.5, and for a man of 58 that was a little too high. However, it
was borderline and I decided to wait for a month before repeating the test. It rose
to more than 5. In consecutive months, it leapt, reaching 10.5.PSA results can
include many false positives and in consecutive prostate examinations there was
no indication of cancer. An ultrasound of my prostate was also normal. However,
in April, a multiple biopsy revealed two malignant traces, neither of which — on
what is known as a Gleason score — appeared to be particularly aggressive.
I had time to decide whether or not I should simply keep a careful eye on things
or take the opportunity of having surgery to remove the prostate. Without
treatment, my PSA score began to fall and Jan and I discussed the perfectly
rational option of watching and waiting.However, she knew and I knew that I
wouldn‟t be very good at that. My instincts were to deal with the cancer as quickly
as possible. And my brother, who had not had the chance of having surgery when
he was diagnosed ten years before, was emphatic in his advice that I should seize
the radical option.
The choice isn‟t straightforward because the side-effects of the surgery are not
insignificant. These were drilled home to me by my excellent urologist, David
Chadwick, at the impressive James Cook University Hospital in Middlesbrough.
I don‟t minimise those side-effects now. Weeks after undergoing the surgery, I
still have to wear a pad at all times to cope with urinary incontinence.
I am luckier than some: I am fine at night and when sitting. Walking and
simultaneously staying dry, however, is pretty challenging.
While my incontinence will get better over the coming months, my impotence —
another consequence of the surgery — may not. Yet it‟s hard to convey the extent
to which these feel like minor inconveniences when my urologist talks of the
probability of my cancer not being managed or controlled, but cured.
So, if you‟re close to 60, or younger, and if there is a family history of prostate or
breast cancer, take a PSA test. If it‟s discovered that you do have cancer, and
you‟re offered the option of surgery, don‟t be discouraged by some of the things
you will read about the side-effects and the potential deterioration in your quality
of life.
I‟m in the midst of those side-effects, and believe me, they‟re worth it.
Martin Narey is a former director-general of the Prison Service and is an
adviser to Michael Gove on social work training.