A delicate operation

By Simon Garfield

The scenery was like nothing they had ever seen before. Last March, 47 cyclists had negotiated a 27km climb to the Puyehue Pass on the border of Chile and Argentina, passing forests and mountains, hot springs and glacial melt-water. At the summit one of them noticed a circling Andean vulture, and they joked that it might be a grim omen. Others noticed that one of their most experienced riders was looking distinctly grey. Roger Kirby, a 62-year-old professor of urology, was taking part to raise money for the Urology Foundation. He had been on similar rides in Malawi and Madagascar and prided himself on his ability to keep up with younger riders, but now he felt severely breathless. His father had died of a stroke following heart failure at the age of 49, and ever since he had been wary of the weight of genetics. So he resolved to have a cardiac check and some blood tests as soon as he returned to England.

The heart exam showed a little calcifying in the arteries, something fairly typical in men of his age, and the blood tests showed another common male attribute: a raised level of prostate-specific antigen (PSA). PSA produces the liquefying component of semen, and may ease the passage of male sperm within the uterus. It is a vital protein for conception, but when it enters the bloodstream in increasing amounts it may also indicate the growth of prostate cancer.