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Prostate cancer: Four in 10 cases diagnosed late, charity says

Image copyright Science Photo Library

Four in 10 prostate cancer cases in the UK are diagnosed late, a study suggests.

The report by charity Orchid found a "worrying trend" of late diagnosis with 37% of prostate cancer cases diagnosed at stages three and four.

The report found one in four cases of prostate cancer was diagnosed in A&E.

In February figures showed the number of men dying from prostate cancer had overtaken female deaths from breast cancer for the first time in the UK.

With an aging population, the charity has called for urgent action to prevent a "ticking time bomb in terms of prostate cancer provision".

Orchid chief executive Rebecca Porta said: "With prostate cancer due to be the most prevalent cancer in the UK within the next 12 years, we are facing a potential crisis in terms of diagnostics, treatment and patient care. Urgent action needs to be taken now."

The report canvassed the opinion of the UK's leading prostate cancer experts and looked at previously published data to get a picture of the prostate cancer care across the UK.

The data came from organisations such as NHS England, charities and the National Prostate Cancer Audit.

The report says that 42% of prostate cancer patients saw their GP with symptoms twice or more before they were referred, with 6% seen five or more times prior to referral.

Greater awareness

Prof Frank Chinegwundoh, a urological surgeon at Bart's Health NHS Trust said: "25% of prostate cancer cases in the UK are diagnosed at an advanced stage.

"This compares to just 8% in the US where there is greater public awareness of prostate cancer and greater screening," he added.

He said while there was controversy over the effectiveness of the standard PSA test used to detect the cancer, "it is still vital that patients are diagnosed early to assess if they need treatment or not as advanced prostate cancer is incurable".

The report also said there needed to be renewed efforts to develop better testing methods.

Prostate cancer symptoms

  • prostate cancer is diagnosed by using the prostate specific antigen (PSA) test, biopsies and physical examinations
  • there can be few symptoms of prostate cancer in the early stages, and because of its location most symptoms are linked to urination
  • needing to urinate more often, especially at night
  • needing to run to the toilet
  • difficulty in starting to urinate
  • weak urine flow or taking a long time while urinating
  • feeling your bladder has not emptied fully
  • men with prostate cancer can also live for decades without symptoms or needing treatment because the disease often progresses very slowly

The PSA test is available free to any man aged 50 or over who requests it, but the report said this can "create inequity" with tests being taken up by "more highly educated men in more affluent areas".

Prof Anne Mackie, director of programmes for the UK National Screening Committee, said the test was not offered universally because it was not very good at predicting which men have cancer.

"It will miss some cancers and often those cancers that are picked up when using the PSA test are not harmful," she explained.

"Treatment for prostate cancer can cause nasty side effects so we need to be sure we are treating the right men and the right cancers.

"There is a lot of research into screening and treatment for prostate cancer and the committee, along with NICE and the NHS, is keeping a close eye on the evidence as it develops," she added.

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Oil prices surge to near four-year high

Oil prices have jumped to the highest level for nearly four years after Saudi Arabia and Russia ruled out any immediate increase in production.

The decision on Sunday was effectively a rebuff to US President Donald Trump, who has called for immediate action to raise global supply.

Brent crude rose more than 3% to more than $81 a barrel on Monday, its highest level since November 2014.

Saudi Arabia dominates the OPEC group of oil-producing nations and Russia is its biggest oil-producer ally outside the group.

They have reportedly been discussing raising output by half a million barrels a day to counter falling supply from Iran.

But a meeting of OPEC and non-OPEC energy ministers in Algiers ended without any formal recommendation for a supply boost.

Mr Trump said last week that OPEC "must get prices down".

Experts estimate that once US sanctions on Iran are fully implemented from November it could result in the loss of as many as two million barrels a day from global supply.

Commodity traders Trafigura and Mercuria said they expected Brent crude to climb above $90 by Christmas and to pass $100 early in 2019.

BNP Paribas oil strategist Harry Tchilinguirian told Reuters Global Oil Forum: "It is now increasingly evident, that in the face of producers reluctant to raise output, the market will be confronted with supply gaps in the next three to six months that it will need to resolve through higher oil prices."

Higher prices tend to mean higher petrol costs.

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However the AA has said other factors, including the strengthening pound over recent weeks, means that wholesale prices have fallen, and that this should help keep the lid on costs.

Meanwhile, higher oil prices tend to benefit UK-listed companies such as BP and Royal Dutch Shell, which employ thousands of people in the North Sea and whose shares are staples in many UK pension funds.

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Trump news: US Deputy Attorney Rosenstein heads to White House ‘to resign’ amid Russia row

US Deputy Attorney Rod Rosenstein, who oversees the special counsel investigation into Russia's role in the 2016 presidential election, is on his way to the White House amid reports he will resign in anticipation of being fired by President Donald Trump.

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Typhoon Trami: Where is Typhoon Trami now? Will it hit Taiwan?

TYPHOON Trami was upgraded to a super typhoon today as the storm gathered strength across the Pacific Ocean. Where is Typhoon Trami now? Will it hit Taiwan?

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Rosenstein could be fired after ‘criticising Trump’

By Lucia Binding, news reporter

The US deputy attorney general has been summoned to the White House where he is expecting to be fired by President Donald Trump.

Rod Rosenstein oversees special counsel Robert Mueller's investigation into possible collusion between Russia and the Trump campaign before the 2016 presidential election.

And Mr Rosenstein has been the inquiry's chief public defender.

He has said he will not resign and that the White House would have to sack him, NBC reported.

Last week, he was reported to have suggested the idea of secretly recording Mr Trump in 2017 after the president had fired James Comey, the FBI director.

Mr Rosenstein also reportedly suggested invoking the 25th Amendment to have the Cabinet remove the president from office.

Mr Trump himself was in New York for a meeting of the UN General Assembly on Monday.

If Mr Rosenstein resigns, the president has more leeway on replacing him, while sacking him would make it harder for Mr Trump to designate a successor.

But NBC News reported that Mr Rosenstein said he would not resign and the White House would have to fire him.

Any termination or resignation would have immediate implications for special counsel Mr Mueller's investigation.

Donald Trump
Image: Donald Trump has been unsure about what to do about Mr Rosenstein following a report in the New York Times

Mr Rosenstein appointed Mr Mueller and oversees his inquiry.

Mr Trump had previously considered the idea of firing Mr Rosenstein in April after FBI raids of the office and home of the president's longtime personal attorney, Michael Cohen.

Cohen has since pleaded guilty to several felonies and taken part in hours of interviews with Robert Mueller.

But the latest move follows the New York Times report of Mr Rosenstein's comments made last year, which played to some of the president's concerns about a secret "Deep State" trying to undermine him from within the government.

Mr Rosenstein subsequently said the article was inaccurate and was based on "biased" anonymous sources "advancing their own personal agenda".

Rod Rosenstein said there would 'always be adversaries' working to 'exacerbate domestic differences'
Image: Mr Rosenstein was reported to have suggested the idea of secretly recording Donald Trump last year

He added: "Based on my personal dealings with the president, there is no basis to invoke the 25th Amendment."

The Justice Department also released a statement from an individual who claimed Mr Rosenstein's recording comment was meant sarcastically.

As of Sunday, Mr Trump has been ambivalent over what to do about Mr Rosenstein.

Some of his confidants urged him to fire Mr Rosenstein, while others suggested he wait and see if the report was incorrect, or if it was planted by some adversary.

Earlier this year, the president publicly denied referring to his deputy attorney general as "Mr Peepers".

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A memo written by Mr Rosenstein, making criticisms of the handling of an FBI investigation into Hillary Clinton's email server, was used by the White House at the time as justification for Mr Comey's firing.

More follows…

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Belluno explosion: ‘Powerful blast’ at Italy train station – several hurt

A "POWERFUL" explosion at a train station in Belluno, Italy, has left several people injured.

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