Prostate cancer survivor’s advice to all men: get a PSA test if you are 50 or over
- Veteran entertainer Anders Nelsson had the shock of his life when he was diagnosed with prostate cancer five years ago. Fortunately, it was operable
- Having taken a doctor’s advice to be screened annually for the disease after reaching 50, he urges other men to do the same, and talk openly about their health
Hong Kong-based actor, musician and former teen idol Anders Nelsson, who fronted the 1960s band The Kontinentals and had roles in Bruce Lee movies, aims to keep the fun in his life – and that of his fans and friends, despite his advancing age. To that end, he is sharing the life-saving advice his former doctor gave him: as you reach midlife, get an annual cancer screening.
In 2015, Nelsson underwent a robot-assisted operation to remove a cancerous prostate gland. Three months later, he returned to the stage at the Hong Kong Cultural Centre for a concert with fellow senior singers including Joe Junior. The audience was unaware that Nelsson was wearing an adult diaper. “It was in case I hit a high note and leaked from the trauma from that,” recalls the 74-year-old Swede, who “had to be carried offstage as I kind of collapsed”.
To explain his return to work so soon after surgery, Nelsson cites his Scandinavian nature, passed down from his father. “It’s the tough genes of being a Viking … I just carried on.”
Prostate cancer is the third most common cancer in men in Hong Kong.
Nelsson’s father, who died in 2003 at age 86, had this illness and underwent brachytherapy, in which small radioactive pellets were inserted into his prostate. Nelsson was oblivious to his dad’s illness and treatment, learning of it later from his younger brother. “Men of that generation didn’t talk about it,” says Nelsson.
This is where he differs from his father. He is openly discussing his affliction to encourage men not to shrug off prostate cancer concerns or believe that it is a “gweilo disease” (affecting only foreign men).
Does diet affect prostate cancer and when should men get tested?
“Chinese people don’t like to talk about anything below the waist or illnesses in general,” says Nelsson. “It’s as if having an illness is considered a weakness.”
Many of his industry peers also stay silent about their harbouring a disease for fear of losing work.
“[Bruce] told me not to move one millimetre forward or he would hit me … I did move slightly,” he recalls. Dr Chu stitched up the wound Nelsson took above his lip.
Chu saved his life in a more consequential way in 1996, the year Nelsson turned 50, having suggested that he start including a prostate-specific antigen (PSA) test in his annual physical, a test that measures levels of a protein whose presence may indicate cancer.
In 2014, an alarming result prompted further tests, including a biopsy.
The seriousness of prostate cancer is measured using a scale known as the Gleason system, which has scores that go from one to five. As Dr Richard Lo Kwong Yiu, urologist and honorary clinical professor of surgery at the University of Hong Kong, who treated Nelsson, explains, the two predominant populations of suspicious cells in a patient are biopsied to produce a “sum score” – of, for example, ‘3+3’ or ‘4+3’.
A sum score of four or above is considered abnormal, and raises questions of the possibility of cancer, prompting further investigations. Lo says: “Three things that make it go up are benign changes, cancer or inflammation.” Nelsson’s test result was “3+3”, meaning he had prostate cancer, but it was slow-growing and not aggressive.
The result came as a surprise to the singer, as he has experienced no symptoms. “Cancer is one of the scariest words in the English language … I felt shock and fear,” he recalls.
Caught early, Nelsson’s condition required only surgery. Lo explains: “If the sum of the Gleason score is six or less, if the patient undergoes proper therapy, chances are he will not die of the disease.”
If the sum of the Gleason score is eight or above, that usually means the cancer has begun spreading from the prostate gland to other organs in the body, Lo adds. This state of affairs, called metastasis, is what causes most cancer deaths.
Nelsson recalls his surgery for prostate cancer. “I can never forget it because it took place on Elvis Presley’s birthday on January 8,” says the singer, who reveres the icon who turned him on to rock’n’roll.
Every day he gets on his stepper to do a 30-minute routine. He also takes a 45-minute stroll in his Yuen Long neighbourhood three times a week. In winter, Nelsson hikes up Tao Fung Shan in Sha Tin, the place where he grew up.
He sings and plays guitar regularly as a creative outlet, and to drive away stress and anxiety. He says exercising his cognitive faculties in this way is also a form of meditation. “You’re concentrating on remembering lyrics and [that’s important] for someone my age,” he says.
Importantly, he gets an annual check-up at Bumrungrad International Hospital in Bangkok, Thailand.
With early intervention to treat his prostate cancer having saved his life, Nelsson urges other men to get the screening from age 50, and stresses that prostate cancer affects all races. “It’s not a lot of money to add it to your annual check-up,” he says.
Why men should always take prostate cancer symptoms seriously
Lo says: “My recommendation is to do an annual PSA test starting at age 50 and people with a family history [of prostate cancer] to start at age 45.”
He urges men to be as vigilant about prostate cancer concerns as they are about cholesterol and heart disease.
