The eight signs that you, like Jeremy Clarkson, could be at risk of prostate cancer. From piling on the pounds to a lower libido, eminent urologist NICK HARDING reveals when you MUST get checked

‘I’ve got cancer.’ Jeremy Clarkson’s quietly spoken words, uttered at the end of Clarkson’s Farm, were met with stunned silence, not just from his close friends on the show, Kaleb Cooper and Charlie Ireland, but from his legions of fans across the country.

The emotional bombshell, dropped yesterday when the final episodes of the latest series were released on Amazon Prime, was preceded by an Instagram message in which Clarkson warned it was a ‘difficult watch’. His words will resonate with the tens of thousands of families affected by prostate cancer, the condition we now know Jeremy has an ‘aggressive’ form of.

Over 56,000 men are diagnosed with the killer disease annually. One in eight will get it in their lifetime and 12,000 men die from it each year.

Mercifully, Jeremy’s was caught early. ‘If I hadn’t got myself checked out this could well have been my last harvest,’ he says on the show. ‘It’s only because they did catch it early, there’s every hope that I’ll be harvesting this farm for many years to come.’

Expert David James, director of patient projects and influencing at Prostate Cancer Research who has been one of the key educators on the disease for the last five years, explains: ‘Given what Jeremy has said, the recommendation would be to act quickly. If it has been caught early, that doesn’t necessarily suggest it has spread. If you catch it at the stage where the cancer is contained within the prostate, the chances of survival are very, very good. There are effective things that we can do to deal with it, whether that is surgery or radiotherapy.’

Indeed, with the limited details available, the prognosis looks positive.

‘Survival rates at ten years after diagnosis are close to 100 per cent, if it is caught early,’ adds James. At stage four, rates plummet to less than 20 per cent.

While it’s not known what treatment Clarkson has received, typically surgery or radiotherapy will be followed with a course of hormone therapy.

The next step would be the removal of a prostate, a procedure known as a radical prostatectomy, which can have profound effects. Men can suffer lifelong impotence, incontinence and bowel problems caused by nerve damage.

Reports that Clarkson has had ‘a percentage of his prostate taken out’ suggest he has undergone a procedure called ‘focal therapy’, a more targeted form of surgery which reduces the risks of side-effects but is not widely offered as standard on the NHS.

‘When caught early, you’re looking at close to everyone surviving, which reinforces why being aware of this disease, getting tested and early diagnosis is so important,’ adds James.

The first stage of diagnosis is a blood test. This looks for raised levels of prostate-specific antigen (PSA), which can serve as a biological signal for the presence of a tumour. If there are indications, this is generally followed by an MRI scan and, if this shows abnormalities, a biopsy is conducted.

Myths around prostate tests can put many men off going for one.

‘There is a myth about digital rectal exams, or the finger in the backside,’ reassures James. ‘If you don’t have symptoms, that is not required. If you’re just going to have a blood test because you’re concerned about risk, there is no reason for you to have that procedure. So don’t let the fear of that put you off going to have a simple blood test.’

Indeed, partners often encourage men to get tested. It’s not hard to imagine that Clarkson’s feisty girlfriend, Lisa Hogan, cajoled him to getting his prostate checked after his heart scare last year, which led to him having stents fitted for blocked arteries.

James continues: ‘Perhaps because screening and routine tests are more common for women, we hear a lot of men say that wives or girlfriends encouraged them to get tested.

‘There are challenges for loved ones when a man is told he has cancer. There’s always uncertainty until you have a full diagnosis and treatment plan and, if caught late, treatments are typically for life and will likely involve some form of hormone treatment, which unfortunately has side-effects.’

For partners, he has this message: ‘Look out for the signs and symptoms and encourage your men to get tested if you’re worried. Just doing it maybe once a year, or every couple of years, can increase your chance of catching it early, rather than when it’s spread.’

Indeed the NHS will be braced for a surge in inquiries about the disease, given that visits to the NHS prostate cancer symptoms page increased by 672 per cent in the 48 hours after Sir Chris Hoy revealed that his cancer was terminal in October 2024.

Here, James explains how at risk you are and how to recognise the signs...

You’ve had your 50th birthday

‘If you’re a man over the age of 50, you are more likely to get prostate cancer. That is a key risk factor. As you’re getting close to 50, start considering prostate cancer and be aware of it. If you are over 50 in the UK, you are entitled to a simple PSA blood test, so if you are concerned, go to your GP and ask for that. It could save your life.’

Your mother or sister has had ovarian or breast cancer

‘If you’ve had a father or a brother with prostate cancer, or multiple relatives, that puts you into a high-risk group. For that reason, it is important to know your family history and find out if you have a family member who has, or had, prostate cancer. This risk factor also extends to female family members who have had breast or ovarian cancer. If these factors apply to you, your risk can more than double, so I would encourage you to speak to a healthcare professional from the age of around 45.

‘Ethnicity also increases risk. Black men have a higher risk than white men so, again, from 45, you should consider talking to a healthcare professional about a blood test.’

You get up more often in the night

‘At first, there are often no symptoms for prostate cancer, which is why it’s important that people are aware of this disease and whether they fall into the high-risk categories mentioned here. One indication, however, can be getting up to pee more frequently, for example if you normally get up twice a night and suddenly that becomes three or four. It is more about a change of patterns, rather than if you’ve always got up several times in the night.’

It’s harder to pee

‘Likewise, changes in urine flow can also be an indication. This can include interrupted flow, finding it difficult to start urinating, having a weak flow or having difficulty while peeing. This is because, as the cancer starts to grow in the prostate, it constricts the urethra, which is the tube that urine flows through.’

Problems in bed

‘Both erectile dysfunction and low libido are another potential indicator of prostate cancer, although they can also be signs of other health issues including high blood pressure, anxiety and stress. If these are your only symptoms, the probability that they are being caused by prostate cancer will be low. They may be a linked symptom but typically you don’t find them in isolation. However, they are still something you should see your doctor about.’

You’ve noticed blood in your urine and/or semen

‘These can be symptoms of prostate cancer, but they can also be symptoms of something else. Either way, they certainly warrant an appointment with your doctor.’

You’re heavier than you used to be

‘While nothing has yet been proven to link obesity with prostate cancer, being overweight creates a higher risk of cancer generally and Prostate Cancer Research has recently funded studies into obesity and prostate cancer, looking at the impact obesity has on the prostate cancer itself.’

You drink and smoke

‘Neither are signs of prostate cancer in themselves, but, if you do end up being diagnosed, the fitter and healthier you are, the better your chances of recovering from treatments. For this reason, I would encourage people to eat a healthy, balanced diet, don’t smoke, and keep alcohol consumption moderate. The healthier you are, the more treatments will be available to you.’