64 Sir Chris Hoy’s stage 4 prostate cancer diagnosis has highlighted the often silent nature of the disease after the six-time Olympic gold medallist revealed that his cancer had already spread to his bones. Hoy, a six-time Olympic champion from Edinburgh, has previously spoken about having no obvious symptoms of prostate cancer. He initially sought medical advice after experiencing shoulder pain. A scan subsequently revealed a tumour, while further investigations found that the primary cancer was in his prostate and had spread to his shoulder, pelvis, hip, ribs, and spine. Dr Karen Faulkner, Associate Medical Director at Panthera Clinic, says Hoy’s experience is a powerful reminder that men should not wait until they feel unwell before taking their prostate health seriously. “Hoy’s diagnosis is a powerful reminder that prostate cancer does not always announce itself with obvious symptoms, and by the time symptoms develop, the disease can already be advanced,” Dr Faulkner said. “One of the most dangerous misconceptions about prostate cancer is that you will know when something is wrong. Hoy’s experience demonstrates why this isn’t necessarily the case. He had no clear warning symptoms and initially sought medical advice because of shoulder pain, only for investigations to reveal that the cancer had originated in the prostate and had already spread to his bones.” “While every patient’s circumstances are unique, his story highlights why men shouldn’t use feeling fit, healthy, or symptom-free as reassurance that everything is fine. Prostate cancer can develop silently, particularly in its earlier stages, which means men need to be aware of their individual risk rather than simply waiting for their body to tell them something is wrong.” Dr Faulkner said symptoms that men should discuss with a healthcare professional include Needing to urinate more frequently, particularly at night Difficulty starting or stopping urination A weak or interrupted urine flow Feeling that the bladder has not fully emptied Blood in the urine or semen Pain or discomfort when urinating Persistent pain in the lower back, hips, or pelvis “However, it is important to stress that prostate cancer may not cause any noticeable symptoms in its early stages. The absence of symptoms should not necessarily be taken as reassurance, particularly for men who have other risk factors,” Dr Faulkner added. According to Dr Faulkner, age remains one of the biggest risk factors for prostate cancer, with the likelihood of developing the disease increasing as men get older. Family history is also important, as having a father, brother, or son who has been diagnosed with prostate cancer can increase an individual’s risk. Ethnicity is another important factor, with Black men statistically more likely to develop prostate cancer and often at a younger age. “These risk factors do not mean that someone will definitely develop prostate cancer, but they can help healthcare professionals assess an individual’s level of risk and determine whether further investigation or discussions about testing may be appropriate,” Dr Faulkner said. “For men who are over 50, have a family history of prostate cancer, or belong to a higher-risk group, Hoy’s story is an important reminder not to wait until something feels wrong before speaking to a healthcare professional.” Dr Faulkner stressed that prostate cancer is not a single disease and that a diagnosis does not automatically lead to the same outcome for every patient. Treatment and prognosis can vary depending on factors including how advanced the cancer is, where it has spread, and how it responds to treatment. “Hoy has also spoken openly about continuing to live his life and finding hope despite his stage four diagnosis. His experience is an important reminder that even when cancer is advanced, patients should have open conversations with their healthcare team about treatment, symptom management, support, and their individual options.” “For anyone who has been prompted by Hoy’s story to think about their own health, this is a good opportunity to speak to a healthcare professional rather than waiting for symptoms to appear.” “The key message is simple: feeling healthy does not necessarily mean you are free from prostate cancer. Knowing your risk, understanding the potential symptoms, and having conversations with a healthcare professional can all play an important role in detecting and managing the disease.” Prostate cancer is the most common cancer in men in the UK. According to NHS information, it often develops slowly and may cause no symptoms for many years. When symptoms do appear, they frequently involve changes in urination, although these can also be caused by non-cancerous conditions such as an enlarged prostate. Men aged 50 and over, those with a family history of prostate cancer, and Black men face an increased risk and are encouraged to discuss testing options, including the PSA blood test, with their GP. Hoy has used his platform to raise awareness and support others living with advanced disease. His case continues to prompt conversations about early awareness and the value of proactive health checks, even in the absence of clear warning signs.