Patient Guide

Prostate Cancer

WHAT IS PROSTATE CANCER

Prostate cancer is the third most common cancer among men in Singapore*. The prostate is a small walnut-shaped gland that produces the seminal fluid that nourishes and transports sperm. It sits below the urinary bladder and in front of the rectum.

The cells that make up the outermost part of the prostate can become cancerous and give rise to prostate cancer. If left untreated, prostate cancer cells may eventually spread and invade distant parts of the body, particularly the lymph nodes and bones, producing secondary tumours.

CAUSES

  • Age: The risk of prostate cancer increases after the age of 50 years
  • Race or ethnicity: Dark skinned men have a higher risk of developing prostate cancer
  • Hereditary: Family history increases the risk of prostate cancer
  • Diet: The risk of prostate cancer may increase with a high-fat diet or obesity
  • High testosterone levels: Risk is increased in men who uses testosterone therapy

SYMPTOMS

Early stage prostate cancer may not produce any signs. As the cancer advances to a later stage, it may produce the following symptoms:

  • Frequent urination, especially at night
  • Weak urinary stream
  • Inability to urinate
  • Interruption of urinary stream

DIAGNOSIS

Screening tests can help to detect prostate cancer early.

  • National Cancer Institute.
    Digital rectal examination
    : This is the first step in diagnosing prostate cancer. The doctor uses a gloved finger to examine the rectum and detect any abnormalities in the texture, shape or size of the prostate gland.
  • Prostate-specific Antigen (PSA): PSA is a substance produced by prostate cells. High levels will warrant further investigation.
  • Transrectal Ultrasound: An ultrasound probe is inserted into the rectum to check the prostate. It makes use of sound waves to create an image of the prostate. Transrectal ultrasound may be used during a biopsy procedure.
  • Biopsy: This procedure involves taking thin sections of tissue from the prostate gland. A positive result for cancer cells may be followed by additional tests to ascertain stage of cancer.
  • Additional tests include:

    • Bone scan
    • Ultrasound
    • Computerised tomography (CT) scan
    • Magnetic resonance imaging (MRI)
    • Lymph node biopsy

TREATMENT

Surgery

Radical prostatectomy may be recommended if the tumour is localised at the prostate. It involves the complete removal of the prostate and often includes the pelvic lymph nodes.

Radiation Therapy

Radiation therapy uses high-energy beams to kill the cancer cells.

Hormone Therapy

In prostate cancer, male sex hormones can cause prostate cancer to grow. Hormonal therapy works by removing the source of male hormones or opposing its action on the tumour cells with drugs or surgery.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells. Chemotherapy is usually given to patients in an advanced stage of prostate cancer when they are no longer responsive to hormonal treatment.

Active Surveillance or Watchful Waiting

Selected persons may be closely monitored by blood tests and biopsies. Treatment is initiated when there is evidence of cancer progression. This is usually used in older men or men with early-stage small volume cancer.

PREVENTION

Prostate cancer cannot be prevented entirely. In general, men are advised to make choices that benefit their overall health such as:

  • Adopt a diet that is rich in fruits and vegetables
  • Exercise regularly and be physically active
  • Maintain a healthy weight

Men aged over 50 years or have a strong family history of prostate cancer, should be aware of the symptoms of prostate cancer, and discuss with their doctors the risks and benefits of prostate cancer screening.

Men aged over 50 years or have a strong family history of prostate cancer, should be aware of the symptoms of prostate cancer, and discuss with their doctors the risks and benefits of prostate cancer screening.

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*NRDO cancer registry 2011

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