The ‘Fry‐Turnbull’ effect

A new report entitled ‘Implications of celebrity endorsement of prostate cancer awareness in a tertiary referral unit – the ‘Fry‐Turnbull’ effect,’ published in the British Journal of Urology International (BJUI,) highlights the effects of celebrity endorsement of cancer screening and the importance this has in raising public awareness.
Following Stephen Fry and Bill Turnbull’s prostate cancer diagnoses, both celebrities spoke out about their prostate cancer journeys in early 2018, urging men around the world to get checked and educate themselves on the symptoms and treatment options available.
Consequently, Prostate Cancer UK reported a 36% increase in treatment for urological cancer comparing April-July 2017-2018, and a 250% increase in visits to the NHS Prostate Cancer advice web page.
Early diagnosis of prostate cancer through a prostate-specific antigen (PSA) test can help to decrease the number of deaths from prostate cancer, and allows for more treatment options, which is why it’s so important for men to get tested, particularly as most men with early prostate cancer don’t have any signs or symptoms.
The results from the study found that there was a “small but important increase (25%) in the number of radical treatments performed, reflecting the detection of cancers that may otherwise have been missed without the celebrity intervention.” However, the study also found that there was a significant effect on the whole cancer pathway, with numbers of referrals dramatically increasing during March – June 2018 and an increased allocation to AS (advanced surveillance) programmes, demonstrating that an additional effect of heightened public awareness is greater detection of clinically insignificant prostate cancer not requiring immediate treatment – and / or greater detection of men presenting at an earlier stage of diagnosis.
What is also of note in the celebrities’ experience is being aware of and educated on the treatment options available. When deciding on his treatment options, Stephen Fry was offered radiotherapy and surgery (radical prostatectomy or RP), where he opted for the latter, describing his treatment as “pretty undignified and unfortunate.”
Indeed, the myths and side effects of prostate cancer treatment can put men off treatment options in order for them to maintain their lifestyle, but this doesn’t have to be the case.
When it comes to discussing treatment options, the first person men speak to in the counselling process – whether that is an oncologist, urologist or specialist nurse – will have a strong influence on the eventual decision regarding chosen treatment. Even patients opting for a second opinion will, more often than not, still follow the advice of the first clinician. It is therefore essential that the first discussion openly and honestly discusses all the potential options.
There needs to be further emphasis and increased education on all the treatment options available for prostate cancer, specifically options which have fewer short- and long-term side effects for many men, such as low dose-rate brachytherapy (LDR-B).
Brachytherapy is a proven, reliable and minimally invasive treatment option that has evolved over 20 years. Despite the availability of brachytherapy services being the biggest barrier of the treatment uptake, evidence shows that the treatment is proven to reduce the risk of side effects compared to other radical interventions, such as radical prostatectomy (RP) or external beam radiotherapy (EBRT). Most men are able to return to normal activities within a few days, with shorter recovery times and better quality of life, convenience and patient experience – making it less disruptive to patients’ lives.
Celebrity endorsement plays a hugely valuable role in raising awareness of prostate cancer, and in encouraging men to get themselves checked, potentially saving lives and almost certainly improving the quality of life of those who may otherwise have remained undiagnosed until a far later stage of disease progression. However, it remains the responsibility of both the medical community and men themselves to ensure they are fully informed of all their treatment options before making a final decision.