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Everything You Need to Know About Prostate Cancer

Introduction

What Is Prostate Cancer

In Singapore, prostate cancer is the 2nd most common cancer diagnosis in men, with 6,283 cases reported between ages 50 to 70 from 2016-2020.

It is a slow-progressive disease where cancer cells grow in prostate tissues. This gland lies below the bladder and in front of the rectum and produces seminal fluid in the male reproductive system. If untreated, prostate cancer may spread to lymph nodes and bones, causing debilitating symptoms. As a result, early diagnosis and treatment result in better cancer outcomes and more manageable complications.

What Is Prostate Cancer

Causes and Risk Factors

What Are the Causes and Risk Factors of Prostate Canc

DNA mutation causes the cells to multiply abnormally, resulting in tumour formation that invades the prostate. Although the cause of the mutation is unclear, certain factors increase an individual’s risk of prostate cancer.

  • Older age
  • Obesity
  • Family History
  • Chemical Exposure

Additionally, genetic mutations to the BRCA1 and BRCA2 associated with hereditary breast and ovarian cancer syndrome may increase the risk of developing a more aggressive form of prostate cancer in men. If you have a family history of breast cancer, consider early prostate cancer screening to detect the disease at a more treatable stage.

Signs and Symptoms

What Are the Signs and Symptoms of Prostate Cancer

Prostate cancer causes no symptoms in some men. However, others may experience symptoms affecting urination and sexual activity similar to other conditions, including enlarged prostate and benign prostatic hyperplasia. As a result, early screening tests are crucial to rule out other related conditions.

Prostate Cancer Symptoms

Burning or painful urination
Loss of bladder control
Erectile dysfunction
Painful ejaculation

Advanced-stage symptoms occur when cancer has spread from the prostate to bones or lymph nodes. It may include leg swelling, hip and feet pain, and bone pain.

Awareness of common signs of prostate cancer results in early detection.

Consult a urologist to understand when screening options are necessary to determine if you’re at risk of developing prostate cancer.

Talk To Senior Consultant Urologist, Dr Terrence Lim

Diagnosis

How to Diagnose Prostate Cancer

Singapore’s prostate cancer screening programme recommends males above 50 years old with a history of prostate cancer go for screening.

If results show you have a higher risk and you’re experiencing symptoms, your urologist may perform additional tests and procedures to confirm the diagnosis and plan a specific treatment.

It starts with a physical exam, medical history review, and the following procedures:

  • Prostate-specific antigen (PSA) tests measure the levels of PSA in your blood. It is a protein produced by the prostate gland. High PSA levels may indicate the presence of prostate cancer. However, prostate inflammation may also cause elevated PSA.
  • A biopsy involves small tissue sample removal from the prostate gland and analysis for the presence of cancer cells. This test helps rule out other medical conditions and confirms the diagnosis.
  • Prostate Cancer Staging determines the extent of cancer and whether it has spread beyond the prostate gland. It uses imaging tests such as CT, MRI, and bone scans

After prostate cancer diagnosis and staging, your urologist will discuss treatment options to support you in making an informed decision.

Treatment and Management Options

What Are Treatments for Prostate Cancer

Treatment for prostate cancer depends on the cancer stage, age, overall health, and personal preferences.

Standard treatment options for prostate cancer include

Prostatectomy
  • Prostatectomy is a surgical procedure to remove part or all of the prostate gland for early-stage cancer. It may involve open, laparoscopic, or robot-assisted surgical procedures.
Prostatectomy
    • Open surgery is suitable for the removal of larger prostates. This requires a larger incision but offers better manual instrument and tissue handling dexterity.
    • Laparoscopic surgery provides precise prostate removal through keyhole-sized incisions with fewer complications, such as reduced blood loss and less postoperative pain. However, this technique may limit vision and the ability to use hands precisely.
    • Robotic surgery uses the da Vinci Robotic Surgical System to make keyhole incisions of 1 cm. It provides the combination of the benefits of open and laparoscopic surgeries with magnified 3d visualisation, shorter hospital stay, and fewer infection risks.
  • Radiation therapy for stand-alone or adjunct treatment. This uses high-energy rays to shrink tumours and kill cancer cells in about 8 to 30 sessions.
  • Hormonal Therapy or androgen deprivation therapy lowers male hormone levels to slow the cancer cells’ growth. It requires regular medication injections or surgical removal of both testes.
  • Chemotherapy uses drugs to treat cancer for advanced prostate cancer and management of severe symptoms.

Patients may also join clinical trials to test new treatments for prostate cancer. This requires a thorough evaluation from your urologist to decide if you’re a good fit for the trial.

How to Manage Prostate Cancer

Ongoing monitoring ensures that cancer does not return or spread. This includes follow-up visits and regular tests such as PSA, imaging tests and physical exams.

In addition, the following may help with physical and emotional recovery after the treatment

  1. Lifestyle changes include a healthy diet, regular exercise and sleep, and limiting stressful triggers.
  2. Support groups and counselling help manage the emotional and psychological changes during prostate cancer treatment and recovery.
  3. Trust a reliable healthcare team with a urologist, oncologist, and other healthcare professionals to continue comprehensive care until complete remission.

If dealing with side effects of surgery, radiotherapy, or chemotherapy, communicate it with your healthcare team to develop a holistic way for the early management of complications.

Prevention

How to Prevent Prostate Cancer

Like other diseases, practising healthy preventative measures may reduce the risk of prostate cancer. This includes regular check-ups for early detection and diagnosis to improve health outcomes.

Here are some tips to stay healthy and cancer free.

Conclusion

Although there’s no proven way to prevent prostate cancer, healthy choices and routine check-ups may reduce your risk. In addition, understanding your family history and awareness of symptoms is crucial to determine when screening is necessary. If you are 50 and above with genetic risk factors, seek medical advice to learn when screening is most helpful.

On the other hand, if you’re diagnosed with prostate cancer, maintain careful monitoring, regular follow-up visits and management of treatment side effects to prevent worsening complications and improve quality of life.

Dr Terrence Lim 2

Talk To Senior Consultant Urologist, Dr Terrence Lim

Resources

  • https://assureurology.sg/prostate-cancer/
  • https://www.singhealth.com.sg/patient-care/conditions-treatments/prostate-cancer
  • https://www.cancer.org/cancer/prostate-cancer/detection-diagnosis-staging/staging.html
  • https://www.cancer.net/cancer-types/prostate-cancer/risk-factors-and-prevention
  • https://www.mayoclinic.org/diseases-conditions/prostate-cancer/symptoms-causes/syc-20353087
  • https://patients.uroweb.org/treatments/open-prostatectomy/
  • https://assureurology.sg/robotic-urologic-surgery/