Some experts are wary of prostate tests. But Wayne Sleep says one saved his life
It spotted his cancer — and now he wants EVERY man to follow his lead and get checked
TEN months after he was diagnosed with prostate cancer, Wayne Sleep is counting his lucky stars. The disease was spotted thanks to a routine blood test — ‘I just feel so fortunate that it was caught relatively early,’ says the former Royal Ballet star, now 67.
The blood test had shown that his levels of prostate specific antigen (PSA), a protein produced by the prostate gland, had suddenly risen from one to five — for a man aged 50 to 59, the reading should be under three, for those aged 60 to 69, under four, and for those 70 and over, under five.
He underwent a biopsy but had to wait several days for the results. The wait was nervewracking, he says, although no one would have noticed.
‘I never showed it — I can’t be bothered with a lot of fuss and would rather be ill on my own, so I downplayed it.’
The results came as a shock. ‘ The urologist was very direct: “I’m afraid you have prostate cancer but it’s all still within the prostate.” ‘I sat there in stunned silence.’ Prostate cancer is graded from one to ten depending on its aggression — the so- called Gleason score.
Wayne’s score was a seven. A Gleason score of six is considered low risk.
‘We usually just monitor those,’ explains Professor Roger Kirby, director of The Prostate Centre in London. ‘But with seven, there is a risk of the disease spreading.’
Wayne asked his urologist to outline the treatment options. ‘It didn’t feel real but inside I knew we had to act on this.’
Wayne was insistent he didn’t want radiotherapy because it involved treatment five days a week for seven weeks. Nor did he want his prostate to be surgically removed.
‘My biggest worry was that I would end up with urinary incontinence,’ he says. ‘I still dance, I do panto and it would be the end of my career.’
Wayne decided on brachytherapy, where tiny radioactive seeds are implanted in the prostate as close to the cancer cells as possible.
It has the same success as conventional treatments but with lower rates of impotence and incontinence. However, complete removal of the cancer is not guaranteed.
‘It is over in a day and that’s what decided me,’ Wayne says.
The procedure was performed in August. ‘I had 56 tiny radioactive pellets fired into my prostate,’ says Wayne. ‘I felt fine afterwards, but couldn’t sleep as I was told they wouldn’t let me home until I had filled a measuring jug with urine to a certain level.
‘I ran the taps, whistled and prayed to God all night. But by 10am I’d produced enough.’
The day after the operation he was allowed home — but with provisos as the radioactive seeds were in place. ‘I was told not to have babies or dogs on my lap.’
JUST two weeks later he went to India to film BBC 2’s The Real Marigold Hotel, where eight senior citizen celebrities spent three weeks assessing India as a retirement spot.
It would be fair to say his doctors weren’t keen on the idea, and the trip was far from plain sailing as Wayne suffered debilitating urinary symptoms when he ran out of vital medication.
And for six months after the treatment, he experienced erectile dysfunction, a temporary result of the brachytherapy.
Not surprisingly, Wayne says he feels ‘more vulnerable than before’.
‘The fear of cancer is there, but I want to use it to urge men to get themselves checked out.
‘Men won’t talk about that area of their body and I admit that when I got a bowel cancer testing kit in the post [as part of the national screening programme for over 60s] I threw it away. How irresponsible. I’ll never do that again.’
And he’s now evangelical about PSA testing. ‘I think every man should have their prostate levels checked by their GP — this disease is life-threatening.’
However the PSA test is controver- sial as it can produce false positive results, meaning men undergo invasive, and often needless, treatment (a raised PSA is often linked to an enlarged prostate, a benign agerelated condition), which is why a national screening programme has been ruled out.
But last week Public Health England issued new guidelines for GPs recommending it be offered to men in their 40s at higher risk (with a close relative who has had the disease).
In fact this wasn’t Wayne’s first brush with prostate cancer detected by a routine blood test.
In 2008 at another regular check-up his PSA ‘suddenly shot up from one to five’. He underwent an MRI scan and a biopsy — ‘when they took the first sample it felt as though I’d had an electric shock and I shot up in the air, and I had to have 12 samples in total.’
The results came back clear and his next PSA reading was back down to one. The results remained
normal for years. But what continued to trouble him were urinary symptoms. These started when Wayne was in his mid50s when he started having to get out of bed once and then twice a night to urinate.
Although symptoms — such as increased frequency, hesitancy, urgency and poor emptying — can be a sign of prostate cancer, typically they are linked to benign prostate enlargement, a condition that affects many men, where the prostate enlarges with age, putting pressure on the bladder and the urethra. Wayne put his symptoms down to ageing and it’s likely he was indeed suffering from an enlarged prostate. But three years ago the symptoms were getting worse.
‘I’d have dinner in the West End and be driving back [home to West London] in a taxi over road bumps, speaking with a squeaky voice as I needed to urinate so urgently and I’d have to run for my front door.’
Then in March 2015 his PSA reading suddenly went up to five again. ‘My private GP — this was a new one as they all die before me — sent me to the urologist. He did a digital rectal examination and suggested I have a biopsy, but I wanted to wait three months, which was when I could have the next PSA test, which is when I would discover if my symptoms were due to temporary infection or inflammation.
‘Maybe that was silly but the biopsy had been so painful before. My GP told me there was a new biopsy procedure but my thought was: “God knows what he’s going to do now.” ’
In June the PSA was as high as before and Wayne agreed to a biopsy. This time he underwent transperineal biopsy, where the needle is inserted between the anus and the scrotum under general anaesthetic rather than from inside the rectum, as with the standard biopsy.
Professor Kirby says this technique is ‘more precise and this is important as prostate cancer is often multifocal, meaning there are various malignant sites within the prostate’.
A few days later Wayne was given the results. ‘I didn’t quite believe I had cancer,’ he says.
Prostate cancer is more common with age and in men from an African-Caribbean background.
Wayne never knew his father, so is unaware of his paternal medical history. ‘ He met my mother Joan when she was working as a waitress in a summer resort. He would say he was coming to get married and then make excuses, such as his car had broken down. It turned out he was already married and hadn’t told her.
‘I was diagnosed in June 2015 and was due to go to India in September, so I didn’t have much time.’ He underwent the brachytherapy in August. After the procedure, he was given Flomax, medication that helps urination by relaxing the muscles in the bladder and prostate.
Patients can be on this drug for life, says Professor Kirby. ‘ It improves urine flow after brachytherapy. If you fill the prostate with radioactive pellets it will swell and can become stiffened with scar tissue causing an obstruction to the urine but this is not incontinence.’
HOWEVER Wayne’s supply of Flomax ran out before he went to India to film The Real Marigold Hotel, and by the final week there, he had an urgent need to urinate but couldn’t.
‘ I’d already confessed to the producers about my surgery during the second week. But they had a show to do, so I didn’t make a fuss, but secretly I worried.
‘I was straight on to the doctor when I returned and the Flomax put things right very quickly. I’m still on it now.’
He also experienced erectile dysfunction for six months. ‘I know that’s not the most important thing in a relationship. It’s the loyalty, the humour, the warmth,’ he says of his long-term relationship with partner Jose.
Since the brachytherapy his urinary symptoms have improved. He will come off the Flomax for two weeks before his next check-up to see if the drug is masking the problem or if it has resolved it for good.
By January, Wayne’s PSA had dropped to 2.5. ‘ When I return in July for my next test we hope it will have dropped further.
‘I don’t want to not live. I’ve got my Foundation which gives scholarships to young people to train them in theatre and dance, and when I’m dead it will have money still. I also run regular workshops all over the country.
‘When I face God, I don’t want to think I could have behaved better.’