There are several factors in Ehud Olmert’s favour. At 62, he is relatively young for a diagnosis of prostate cancer. He is physically fit, a keen runner who takes daily exercise, and has even been described as an exercise fanatic.

We can also reasonably assume that he received an early diagnosis. Israeli medicine is good and thorough, and it is likely that he has had regular PSA (prostate specific antigen) testing - a simple blood test that can show whether further tests such as an ultrasound and biopsy are needed.

Politicians tend to be optimists and it may well be that Mr Olmert will have no further trouble once he has had radical surgery or irradiation. However, it would be an unusually benign tumour for a patient’s chances to be as good as that of a 95 per cent complete cure.

The prognosis in prostate cancer depends on the size of the gland, the PSA score — which should be less than ten for the best results — and the Gleeson score. This is the measure of the malignancy of the tumour, and is graded from two to ten. Patients with a Gleeson score of two, three or four need be in no great hurry for treatment as they, other factors being equal, tend to do well.

Those with a score of five, six or seven need early radical treatment by surgery or irradiation, but usually have a good chance of doing well. A patient with a Gleeson score of eight, nine or ten needs immediate attention and possibly additional therapy. They are likely to do less well.

Another factor is whether the tumour is in both lobes of the prostate gland or confined to one side. Those in which the cancer is in both lobes do less well, as do those in whom the rest of the prostate tissue shows signs of pre-malignant change.

Patients with prostate cancer in the least malignant group can be treated initially, should the patient want it, by active surveillance, regular checks every three months and no immediate active therapy.

Surgery is still the treatment of choice for most people. The best form is arguably robotic surgery, in which the high magnification that the endoscope gives the surgeon as well as the increased intra-abdominal pressure provided by the anaesthetist reduces the bleeding that used to complicate standard prostatic surgery.

The two other surgical possibilities are the standard radical surgery under direct vision and endoscopic keyhole surgery without a robot.

Irradiation was only palliative until a few years ago but is now so increased in efficiency and can be so well directed at the tumour that it is possible to use computer-controlled external beams to give much larger and therefore efficient doses of irradiation. These doses are now big enough to destroy the cancer cells without irretrievably damaging the surrounding tissue.

Another sort of radical therapy is brachytherapy. This is the implantation of radioactive material into the prostate gland. It is claimed that this gives comparable results to radical surgery without having such a drastic effect.

The high death rate from cancer of the prostate will be controlled only when annual screening for men, as recommended by the American Cancer Society, is introduced for all men at 50 and for those of increased risk at 40. The PSA can now be supplemented not only by transrectal ultrasound and biopsy, an expensive procedure, but by genetic testing for prostate cancer with a non invasive test, the PCA3.

For cases of prostate cancer diagnosed late, chemotherapy and hormone therapy have improved beyond recognition within the past ten years.

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