Every once in a while you read a great article that stirs you to your core. I would like to praise Angela Epstein who interviewed Professor Roger Kirby, Director of The Prostate Centre in London, for her fantastic interview with Professor Kirby in the Good Health section of the Daily Mail on Tuesday 26 August. Professor Kirby was very candid in his interview entitled, “Why all men over 50 must demand a prostate test – it helped save my life”. He describes his diagnosis with cancer about a year ago. Because of his specialist knowledge he was able to act quickly when he suspected the disease and because he had the best tools at his disposal he was able to give himself the best chance at beating it.But most men aren’t so lucky. Epstein states that unfortunately most of the 40,000 men diagnosed with prostate cancer in Britain each year cannot bank on such in-depth expertise. There is more of an arbitrary approach to the diagnosis, which is usually driven by symptoms such as rushing to the bathroom or a conscientious GP who does a check-up of the prostate and provides PSA (prostate specific antigen) test.It always puzzled me that there is no National screening programme for prostate cancer; with my public health hat on I feel there should be, many other doctors would believe that as well. But a European randomised study of screening for prostate cancer involving 162,000 men aged between 50 and 74 concluded that, whilst screening could save around 2,300 lives in Britain annually, 2 out of 5 men who were told they had cancer would be over-diagnosed (i.e. they will be diagnosed even thought the disease would never cause symptoms or death in the patient). Epstein suggests that this could lead to unnecessary investigations such as biopsies, radiotherapy or even surgery. However, the article then states that over-diagnosis could be ruled out if every man over 50 were to ask for an annual PSA test. Anyone with the raised level could then have an MRI scan performed to identify the presence or extent of cancer. Epstein correctly deduces that that doing this could eradicate the scattergun approach with biopsies that could cause side effects and intense anguish.I was very happy to hear of Professor Kirby’s own personal experience, but as is stated at the very beginning; knowledge is power. Finally, the article goes on to state that since 10,000 men are dying of prostate cancer every year, his advice would be that men over 50, especially those with a risk factor such as family history, should have a PSA test. And don’t be distracted by a GP who says results are unreliable.I would like to congratulate Professor Kirby as this prompted me also to rethink my ideas and made me also aware of the necessity and the value of having this test performed. In a recent report it has been stated that sugar is as dangerous as alcohol and tobacco and it goes on to state that Britain’s obesity crisis could be reversed within five years if food companies reduce sugar in products by 30%. Wow! This is an incredibly surprising statement.For me, the obesity crisis has a great deal more to do with the lack of physical activity and regular exercise, not purely sugar intake. And I can’t help but recall the days when the first cotton candy machine came to my street. I grew up in a neighbourhood of about 15 kids and when this cotton candy machine came we used tons of sugar and obviously loved it. But when I was growing up I don’t remember seeing many obese children. It’s only now, over the last 25 years, that we have seen such dramatic increase in obesity. Why is that? We were eating our fair share of sugar when I was growing up – so sugar can’t be held completely accountable.I go back to my point that it is not only our diets but again the lack of physical activity that is perpetuating the obesity crisis – children being driven to school and not walking or riding their bikes, after-school physical activity programmes dwindling, kids becoming addicted to their iPads and Playstations. But I have to concede that it would be a good idea to cut at least 100 calories from each person’s daily diet – and with the high content of sugar in many of today’s processed foods I have to agree that these levels must be lowered if we’re to see improvement.Simon Capewell, a Professor of Clinical Epidemiology, states that sugar is the new tobacco and I agree with his sentiments: ‘Everywhere, sugary drinks and junk foods are now pressed on unsuspecting parents and children by a cynical industry focused on profit not health. The obesity epidemic is generating a huge burden of disease and death.’It is also stated that 1 in 4 adults in England is obese and these figures are set to go up to 60% of men, 50% of women and 25% of children by 2050. The incidence of type 2 diabetes leading to cardiovascular disease and morbidity is going to be unmanageable unless this stops. Currently, obesity and diabetes already cost the UK £5 billion every year and experts state that it could reach £50 billion in the next 36 years. This is an astronomical rise, and should have us all very worried.So, is taxing the food industry the right way to go or should we be focusing on education? There is a general consensus that children are the primary targets of food marketing and as a very vulnerable group, heavy marketing of sweets and sugary drinks contributes to skyrocketing childhood obesity. I am of two minds here. I am a huge advocate of public health and believe that it’s vital for public health officials to educate us in the right choices. But, I think somewhere along the line we must take responsibility for ourselves as individuals; we can’t always blame everyone else for our problems. I do feel deep down that the government has a role to play with healthy messages to deal with the ill effects of high calorie intake, but it must be a structured push from the government and ultimately the onus lies with us to take action.I am still very happy that this report didn’t come out when I was a kid, as I’ll never forget those fantastic days when we had our own cotton candy machine. I started this blog with the idea of looking at sports and medicine and life and the intrinsic relationship that links these three elements. In other words, I wanted to discuss other relevant medical topics. With this in mind, it’s absolutely imperative that I address the latest medical crisis, the Ebola outbreak.It’s vital to understand that this is not just an African problem. I say that because I can remember as a medical student, when HIV first came to prominence, many people thought it was a problem limited to the Gay community and most heterosexuals felt safe and that it was not their problem. As we all know now, this was not the case. The same is true of the Ebola virus. This is not a problem that we can sweep under the rug or confine to certain part of the world – this is a global crisis and the sooner we recognise that the better.The Ebola viral disease is severe and is reported to be 90% fatal in humans. It first appeared in the mid-1970s in a village situated near the Ebola River from which the disease takes its name. The virus is transmitted through close contact of bodily fluids such a sweat and blood. The symptoms include fever, muscle pain and sore throat which rapidly escalate to diarrhoea, vomiting and external and internal bleeding. When you think how this virus is transmitted, you have to consider whether could it affect sporting competition, especially in contact sports such as football.The World Health Organisation (WHO) and the US Center for Disease Control (CDC) have both said that the risk of Ebola spreading beyond Western Africa is extremely low. In fact, Gregory Hartl, a spokesman for the World Health Organisation, stated that the virus is actually difficult to transmit. But just imagine what would happen if Ebola came to the UK? Despite what the WHO and CDC state, I don’t think this scenario is as far-fetched as it might sound – especially with air travel as common as it is. Borders don’t mean as much as they did in the past.Remember, this is not just an African problem… this is a World problem.