The ‘Man Van’, an innovative new outreach programme, was launched in March this year to provide free health checks for men and boost early diagnosis of prostate and other urological cancers.
The mobile health clinic will visit workplaces and churches in London, starting in Croydon, to improve healthcare access for men who are less likely to receive regular health checks, and are at risk of having cancer diagnosed late, when it is more difficult to treat.
The programme, developed by The Royal Marsden NHS Foundation Trust, RM Partners West London Cancer Alliance, and The Institute of Cancer Research (ICR), London, will focus on men of working age who often have worse prostate cancer outcomes than older men, particularly those in manual jobs who often struggle to access healthcare. Black men, who have roughly double the risk of developing prostate cancer and an increased risk of death once diagnosed, are also being encouraged to get checked.
With over 50,000 cases each year, prostate cancer is the most common form of male cancer in the UK [1]. It is also the third biggest cancer killer in the UK and in 20% of cases in England men only seek medical help when their cancer is at an advanced stage and too late to cure [2].
The pilot programme will investigate whether this care model can improve diagnosis and survival of men in these high-risk groups. If successful, the approach could be rolled out more widely across the NHS.
The Man Van – Promoting Men’s Health across London for
Royal Marsden NHS Foundation Trust (by Sam Mellish Photography).
The interior of the Man Van (by Sam Mellish Photography).
Since launching, the van has offered appointments to employees of the construction company Lendlease at a construction site in Croydon as well as employees of the waste, water and energy management company Veolia. There are plans for the van to eventually visit sites across West London.
The van has a built-in clinic space where, if appropriate, men are given prostate specific antigen (PSA) tests, as well as tests for common health conditions like diabetes and hypertension.
After each clinic, a Royal Marsden nurse will discuss the findings with those assessed and, with their consent, share this information with their GP. If necessary, men are referred to a specialist service by the van’s consultant, also from the hospital, for further investigations or treatment. If an increased risk of cancer is potentially detected, The Royal Marsden, a world-class cancer centre, will be offered as a referral option along with their local hospital.
The van is visiting workplaces in partnership with the British Trade union, Unite the Union, along with community organisations, such as support groups and churches in Croydon.
The Man Van will also provide men with an opportunity to take part in clinical trials which aim to improve survival from prostate cancer, carried out by The Royal Marsden and ICR, one of the world’s most regarded cancer research organisations. This includes the PROFILE study which aims to understand why some men, including black men, are at greater risk of prostate cancer, and develop new ways to improve diagnosis and treatment.
Professor Nick James, ICR.
Understanding the genetics that influence the risk of prostate cancer could improve the way we screen men for prostate cancer in future, and help more men get diagnosed and treated early.Professor Nick James, Professor of Prostate and Bladder Cancer Research at ICR, London, and Consultant Clinical Oncologist at The Royal Marsden NHS Foundation Trust, said: “The earlier cancer is detected, the more effective the treatment, and speeding up cancer diagnosis can transform survival rates. Unfortunately, we know men often seek medical help for the disease and other serious conditions at a late stage. That’s why we’ve developed the Man Van. The van offers a private and relaxed space where men can come and chat about their health, be supported by clinicians and receive simple but potentially life-saving tests. We’re bringing the van straight to men at work and in the community so that we can boost early detection and treatment in men who might otherwise only see a doctor once their cancer has progressed. If the Man Van proves to be an effective model, we hope to see the approach rolled out more widely across the NHS.”
Linford Christie OBE’s mum worked as a nurse at The Royal Marsden
and he has backed the launch of the Man Van service.
The new service has also been backed by former Olympic athlete and prostate cancer campaigner Linford Christie OBE. Linford said: “My mum worked as a nurse at The Royal Marsden, and I’m thrilled that the hospital is launching this brilliant new service, in collaboration with RM Partners and the Institute of Cancer Research, London, to address male health inequalities and get prostate and other urological cancers diagnosed faster. I was completely shocked when I first heard that one in four black men will be diagnosed with prostate cancer and are more likely to die from it too. It’s fantastic that the Man Van is trying to boost early detection of prostate cancer amongst high-risk communities and those who are less likely to receive regular health checks. Guys, if you have the chance to book an appointment in the van, please go for it. It could save your life.”
Along with funding from RM Partners and the ICR, the Man Van has also received support from The Royal Marsden Cancer Charity and Tackle Prostate Cancer.
Patient testimonials
Ernesto Montero, a 50-year-old man from Finsbury Park, was able to book an appointment in the Man Van through his employer, TGN Construction,when it visited the Ruskin Square construction site in Croydon. Tests revealed Ernesto has high PSA levels, so he was referred to The Royal Marsden for further investigations, including a prostate biopsy. He said: “When I was offered the opportunity to have an appointment in the Man Van, it was a no brainer. The van is so close to my work and booking an appointment was really easy – it was a perfect opportunity to have a health check. I live in North London and work long hours in Croydon so finding the time to book a GP appointment is hard. I also felt fine, so I didn’t think there was anything to worry about.
“During my appointment in the van, I had my PSA levels tested for the first time. My father had cancer, but it wasn’t in his prostate, and I wasn’t really aware of the test or any signs and symptoms of the disease. The Man Van staff were very helpful and made me feel comfortable and relaxed the whole way through.
“The results revealed that my PSA levels are a bit high for my age, and I was referred to The Royal Marsden straight away for more blood and urine tests, along with an MRI scan and a biopsy. Fortunately, no cancer was found. For monitoring, I’ll go back to the hospital for another PSA test in six months and an MRI scan in a year.
“I would 100% encourage others to book an appointment in the Man Van if they have the chance. Men always use the excuse that they’re too busy, especially with work, to look after their health, but we really should take more care of ourselves.”
Bishop Mark Nicholson, a 59-year-old from Purley, also attended an appointment in the Man Van when it visited Acts Christian Church in Croydon. He organised for clinicians from the van to host a special Sunday service to raise awareness of prostate cancer, which was attended by neighbouring congregations. He said: “Before getting involved with the Man Van, I had no idea that one in four black men will get prostate cancer in their lifetime. It was terrible to find out the risk is so high. Most of my congregation are black and, over the years, I’ve sadly carried out the funerals of many people who have died from the disease.
“Now I know more about the signs and symptoms to look for and the importance of PSA testing, I’m determined to offer more practical help from the pulpit and raise awareness of the disease. Since the Man Van visited my church, many men have approached me to say, were it not for the van, they wouldn’t have known they have high PSA levels. It could have saved their life.
“When I had my own appointment, I found the van to be a soothing and comforting place, like a home from home. A doctor and nurse were on hand to support me and were very helpful, calmly guiding me through the process. Fortunately, my results came back fine which was very reassuring. However, it was good to know if anything was detected, be it abnormal PSA levels or another problem, both myself and my GP would have been informed. It felt like a lot of care and support rolled into one package.”
References
1. Cancer Research UK.
https://www.cancerresearchuk.org/
health-professional/cancer-statistics
/statistics-by-cancer-type/prostate-cancer
(accessed 17 March 2022).
2. Cancer Research UK. Early Diagnosis Data Hub.
https://crukcancerintelligence.
shinyapps.io/EarlyDiagnosis/
(accessed 17 March 2022).
Acknowledgement: Photographs copyright © The Royal Marsden.
