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Conditions
What is Prostate Cancer?
The third most common cancer among men in Singapore, prostate cancer begins when growth of normal cells become uncontrolled, with the potential to metastasize and spread to nearby and distant organs if not promptly treated.
There has been a rising incidence over the decades and it primarily affects older men above the age of 50.
Am I at Risk?
Risk factors of prostate cancer include:
- Being above 50 years old
- Having a family history of prostate cancer
- Having high-fat and low-fibre diets
- Being a smoker
- Being exposed to heavy metals e.g. cadmium
What are the Signs & Symptoms?
Early-stage prostate cancers usually do not cause symptoms as the cancer is usually a slow-progressing one. These cases are often detected only after a screening.
Advanced prostate cancers, however, may cause symptoms such as:
- Difficulty urinating
- Having a slow urine stream
- Waking up at night to urinate
- Blood in the urine or semen
- Loss of weight and appetite
- Difficulty getting an erection
- Pain in the pelvic area and lower back
- Weakness in the legs
- Decreased bladder and bowel control
As many symptoms of prostate cancer overlap with other benign prostate conditions, it is crucial to be aware of your risk levels, know what to look out for, and seek medical attention.
Contact UsDiagnosing Prostate Cancer
There are several methods that urologists can use to diagnose prostate cancer:
1. Digital Prostate Exam
- A straightforward test, the urologist will simply insert a gloved, lubricated finger into the anus and feel for the prostate. They will check for its size, texture and consistency. Should there be hard or lumpy areas, you will be advised to go for further testing.
2. Prostate-Specific Antigen (PSA) Test
- This is usually used for patients at higher risk of prostate cancer, or who display symptoms.
- This is a blood test that detects suspected prostate cancer (via elevated PSA levels).
- As it is not highly accurate (elevated PSA levels can also be caused by non-cancerous reasons), further tests will be needed to prove a cancer diagnosis.
3. Prostate Biopsy
- The results from the PSA test will help your urologist determine if a biopsy is needed to confirm your diagnosis.
- A prostate biopsy is usually only recommended after the urologist has reviewed the patient’s age, family history, ethnicity, overall health and past biopsy results (if any); and thinks that there is still a reasonable risk of cancer present.
- A prostate biopsy is not to be taken lightly as there is a risk of infection. It also results in temporary pain and bleeding in urine and semen.
4. MRI-Guided, Targeted Prostate Biopsy
- The traditional way of performing a prostate biopsy is done in a “blind” manner, where 12 tissue samples will be randomly taken from the prostate.
- This means that there is a chance that a cancer might still be missed; which may result in a repeat biopsy if the patient’s PSA levels remain elevated.
- With this new technology, a patient will first obtain an MRI scan of their prostate, which helps identify suspicious lesions. The MRI image is then then fused with an ultrasound image of the prostate to pinpoint suspicious areas to obtain a biopsy from.
- The resulting clarity and precision help to improve the accuracy of the test, and reduce the need for multiple biopsies.
5. Prostate MRI Scan
- This is a non-invasive imaging test that is used to evaluate the extent of prostate cancer and determine whether it has spread beyond the prostate.
Dr Michael Wong has over 30 years’ experience in the diagnosis and care of prostate cancer. Contact us for an accurate and individualised assessment today.
Contact UsHow is Prostate Cancer Treated?
Every patient is different – some are young, some are old, some have an aggressive form of prostate cancer, some have a slow-progressing one, some have early-stage cancer, some have advanced cancer.
As such, it is the challenge that urologists face when deciding between various modes of treatments as well as close monitoring (no treatment), all with the patient’s best interests in mind.
Close Monitoring
In cases where the cancer is small and slow-progressing, the urologist may recommend close monitoring with regular PSA tests, periodic MRI prostate scans and repeat prostate biopsies when a follow-up check is due.
If and when it gets to a point where treatment is deemed necessary, your urologist will identify the most effective treatment plan suitable for your condition
Radical Prostatectomy
A prostatectomy involves the partial or total removal of the prostate, along with the seminal vesicles.
Laparoscopic Technique
Nowadays, a prostatectomy is done laparoscopically through a few small incisions in the abdomen and long surgical tools, compared to the traditional open approach of the past. With this minimally invasive approach, patients can expect to recover faster with reduced post-operative pain.
Robotic-Assisted Technique
A robotic system (controlled by your urologic surgeon) provides high levels of magnification, clarity, dexterity and precision. With a robotic system, there will be no human tremor of the hands, nor the limitations of our natural vision. Your urologist will determine if a robotic prostatectomy is suitable for you.
Radiotherapy
Using high-energy rays aimed at the prostate, radiotherapy destroys targeted cancerous cells without affecting surrounding structures. It can be used in the following situations:
- As the initial treatment for localised, low-grade prostate cancer
- As part of the initial treatment (along with other treatments) for cancers that have spread beyond the prostate and into surrounding tissues
- If the cancer was not fully removed, or if the cancer recurs after surgery
- To provide comfort by relieving symptoms and keeping the cancer under control for as long as possible
Hormone Therapy
The goal of this treatment is to reduce the production of male hormones (in particular, testosterone) in order to stop them from fuelling cancer cells. The cancer usually shrinks upon the stopping of testosterone production. This can be done through medications, injections, or removal of the testicles.
Hormone therapy is only recommended if the cancer has spread too extensively to be cured by surgery or radiotherapy; or if the cancer either remained or returned after surgery or radiotherapy. It may also be used to reduce the size of the cancer prior to radiotherapy treatment.
Chemotherapy
Usually administered intravenously, these anti-cancer drugs travel through the bloodstream to reach and destroy cancer cells in the body. However, they also destroy fast-dividing healthy cells in the process, such as the hair follicles and the bone marrow (where new blood cells are made).
In treating prostate cancer, chemotherapy is usually recommended when the cancer has spread beyond the prostate or when it did not previously respond to hormone therapy.
Our prostate cancer surgeon is experienced in the treatment of all types of prostate cancers; so you can rest assured knowing that you’ll receive only evidence-based and compassionate care.
Contact UsDr Michael Wong
Medical Director & Senior Consultant Urologist
FAMS (Urology),FICS (USA),FRCS (Edinburgh),M Med (Surgery),MBBS (Singapore)
With over 30 years of experience, Dr Michael Wong is a reputable urologist of international standing. He is particularly passionate about the detection, prevention and treatment of prostate conditions; and is skilled in minimally invasive procedures for better outcomes. Over the years, Dr Wong has kept himself actively involved in leadership roles in renowned urological organisations around the world.
Award 2018
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Prostate problems are common and can be benign or malignant. With timely diagnosis and treatment, you can regain a healthy and comfortable lifestyle.
For further enquiries, please contact our specialist clinic today
Mount Elizabeth Medical Centre, Singapore 228510
