Back in 2004, chartered accountant Graham Fulford realised that he hadn’t heard from his client Jim Walton, founder and owner of a Penrith Toyota dealership, for around four months. Alongside their business ties, the two had become close personal friends; Fulford was used to catching up with Walton by phone every few weeks.

A couple of days after Fulford had made a mental note to get in touch, Walton called him. It was bad news. Fulford knew his friend had been struggling with back pain for some time. It turned out that Walton had prostate cancer. According to the diagnosis, his condition was quite advanced and severe.

Just two weeks later, while Fulford was still trying to absorb the shock of Walton’s news, his wife’s brother-in-law Peter also announced that he had prostate cancer. Both men had been diagnosed too late. Walton survived for only two years after his diagnosis. Peter lasted a little longer, but eventually suffered what Fulford describes as an “awful, painful death” in the grip of creeping paralysis.

In the wake of these terrible deaths, Fulford decided to do what he could to raise awareness of prostate cancer.

Supportive environment

Fulford had begun his accounting career in 1964, taking his ICAEW training as an articled clerk with a small firm in Leamington Spa. Having qualified in 1970, he immediately went to work with PriceWaterhouse in Birmingham, before opening his own practice. The venture led him to the South West and back to Leamington. Along the way, he steadily built up a client base across the UK. Without necessarily knowing it, Fulford had built some impressive networking skills, which helped him to form an innovative response to the upsetting news he had received in 2004.

He first got in touch with the organisation that would become Prostate Cancer UK – then and now the nation’s biggest charity in the field. He told them he wanted to make a difference in early diagnosis. “My pitch was, ‘Give us 75 places with you on the Great North Run, and we’ll help you raise £100,000.’ They explained that cracking early diagnosis was very difficult. But I said it was a big passion of mine and we’d run to fund their research.”

As the running team took shape, one member told Fulford that his wife worked for a rehab hospital. He asked whether it would be possible to use some of the money to buy a mobile bladder scanner for the facility. That way, men in the local (largely rural) area could get checked without being put off by the lengthy travel distance to the hospital. Following the run, they got the scanner, which led to the next fruitful connection.

“The scanner was presented to the hospital by a lovely lady from the manufacturer’s agency,” Fulford explains. “We got on really well, and she instantly saw how passionate I was about early diagnosis. She said her company held lectures every three months for specialist nurses and other prostate experts, and invited me to the next one as I’d meet lots of relevant people.”

At the event, Fulford met a man called Colin, who told the incredibly moving story of his own diagnosis. Colin then introduced Fulford to prominent urologist and early diagnosis advocate David Baxter-Smith. The germ of a bold idea took root as a result. Fulford explains: “I told David about the scanner, and he explained that a much better method for early detection was the prostate-specific antigen (PSA) Test, which has a hit rate of around 25% of results outside normal range.”

In October 2005, Fulford launched a charity to hold events enabling men to submit PSA Tests in a collectively supportive environment. The Graham Fulford Charitable Trust was born, and yielded immediate results. “Our very first event discovered two cancers,” Fulford says. “One was found in a man of 68 and was quite advanced, but still early enough for him to receive reasonable treatments. He ended up surviving into his early 80s.

“Right up to the end, he was a big supporter of ours, attending most of the events we held in Warwick as an advocate for our work.”

Cultivating links

By 2014, the Trust had chalked up a cumulative 40,000 tests and was processing around 10,000 per year. It is now approaching 300,000 tests over 20 years, at a current annual rate of 60,000 to 70,000. It has found more than 3,000 cancer cases to date. In the course of those two decades, the Trust’s workflow has become increasingly sophisticated, evolving from what Fulford calls its “Heath Robinson-style” beginnings. The Trust now offers home-testing kits, backed up with a detailed online questionnaire and database to pinpoint subjects’ risk levels and needs for ongoing surveillance.

Along the way, Fulford has built an impressive roster of medical partners to help process the tests and advise the Trust. Those include independent London-based pathology experts The Doctors Laboratory, and Professor Hashim Ahmed, renowned Chair of Clinical Urology at Imperial College London and head of the £42m TRANSFORM Trial, which aims to pave the way for a much-needed national prostate cancer screening programme.

In parallel, Fulford has cultivated links with an array of companies, industry bodies and trade unions to maintain a pipeline of test subjects and spread awareness of the disease. In some cases, those stakeholders will part-fund tests on behalf of the subjects. In others, they will work with a sponsor to cover the costs. Alternatively, subjects can pay for themselves. Tests cost £25 to £30 each, depending on location, and the Trust works as a nonprofit.

More recently, it has broadened its offering to provide tests for health issues such as cholesterol, diabetes and liver function, which means that it is now testing women, too. “Of the first 8,000 tests we did in those additional areas, around 45% were outside normal range,” says Fulford.

In November 2023, the Trust was granted the King’s Award for Voluntary Service (KAVS) – and in the 2024 King’s Birthday Honours announced in June, Fulford himself was awarded the title Member of the Order of the British Empire, for Services to Prostate Cancer Awareness and Early Diagnosis.

Fulford credits his accountancy background as instrumental for laying the Trust’s foundations. “I keep an iron rod on the finances, and that comes from my training,” he says. “Plus, it helps my negotiations with labs and other partners. I couldn’t have done any of this without those skills.”