Gabby Logan has posed an important question to a surgeon regarding prostate cancer recurrence, following her husband Kenny Logan's fight against the illness. The former rugby international received his prostate cancer diagnosis in 2022 after taking a Prostate Specific Antigen (PSA) test, despite experiencing no worrying symptoms.
The examination showed that the 54-year-old's PSA levels exceeded normal ranges, leading to additional investigations. After his diagnosis, Kenny had an operation to have his prostate removed and received the all-clear in February 2023.
Since gaining deeper insight into prostate cancer – Britain's most frequently diagnosed cancer among men – Gabby admitted her astonishment upon learning that the condition can potentially return, even following prostate removal.
In conversation with Professor Vaibhav Modgil, a Consultant Urological Surgeon at Manchester Royal Infirmary and among Britain's Andrology specialists, she remarked: "I think this is the thing that people find difficult to understand, if you've had your prostate removed, how you can get a recurrence of prostate cancer?"
"And that is, you know, I know from Kenny's experience, every six months, he's got one coming up, he has to do [blood tests]. I'm like how? Because if you haven't got a prostate, how are you going to get prostate cancer?"
"I try and think of it in women's terms, so women who know they've got the BRCA gene and have a double mastectomy, so [it significantly reduces the risk of] breast cancer, but it's not the same thing," she added on her The Midpoint podcast.
The professor responded by explaining: "No, it is and it isn't, I'm not a cancer pathologist or a cancer specialist, but the entire idea of surveying people in terms of doing blood tests, scans, etc also hinges very closely on the kind of disease they had in the first place."
"Not all prostate cancers are the same, so if you've got a localised prostate cancer and it's been definitively treated with surgical margins and negative, and depending on the initial grade of your prostate cancer, you're likelihood of reoccurence might be drastically different to an individual who, for example, had a high grade prostate cancer, but none the less they all require surveillance," he continued.
The expert went on to stress that there is no "one size fits all" approach to the condition. Prostate Cancer UK defines recurrent prostate cancer as cancer that returns following treatment that was intended to be curative, also commonly known as prostate cancer recurrence or relapse.
Previous treatments that patients may have undergone include: Surgery (radical prostatectomy), External beam radiotherapy (EBRT), Permanent seed brachytherapy, High dose-rate brachytherapy, High-intensity focused ultrasound (HIFU) and Cryotherapy.
Prostate cancer can recur even after the gland has been removed, typically for one of two reasons – either microscopic cancer cells remained in the tissue surrounding the "prostate bed" following surgery, or the cancer had already spread beyond the prostate before its removal.
The charity points out that while these treatments aim to eradicate prostate cancer completely, sometimes not all cancerous cells are successfully eliminated, or the disease may have progressed further than originally believed.
Should prostate cancer make a comeback, the initial indication is usually an increase in PSA levels rather than noticeable symptoms emerging. Nevertheless, patients are urged to get in touch with their doctor or specialist nurse if they notice any new symptoms or side effects, or if they have concerns that their cancer might have returned.
