Prostate Cancer Treatment | Allen Sim Urology

Prostate Cancer

What is prostate cancer?

Prostate cancer is a malignancy that originates in the prostate gland, a small, walnut-shaped organ in men responsible for producing seminal fluid, which nourishes and transports sperm. Located below the bladder and in front of the rectum, the prostate surrounds the urethra—the tube through which urine exits the body. This anatomical positioning means that changes in the prostate can affect urinary functions.

In prostate cancer, cells within the gland undergo abnormal growth, forming tumours that can potentially spread to other parts of the body. It is one of the most common cancers among men, particularly those over the age of 50. While some prostate cancers grow slowly and may not cause significant harm, others are more aggressive and require prompt treatment.

What causes prostate cancer?

Prostate cancer develops when cells in the prostate gland undergo genetic mutations that disrupt normal cellular functions, leading to uncontrolled growth and tumour formation. These mutations can activate oncogenes, which promote cell proliferation, or deactivate tumour suppressor genes, which normally regulate cell division and prevent tumour development.

A significant factor in prostate cancer progression is the role of androgens—male hormones such as testosterone—that stimulate prostate cell growth. Cancerous cells often exploit the androgen receptor pathway, becoming hypersensitive to these hormones, which fuels further growth. Additionally, mutations in genes responsible for DNA repair, such as BRCA1 and BRCA2, can lead to the accumulation of genetic damage, increasing the risk of cancer development.

Epigenetic changes, which alter gene expression without changing the DNA sequence, also play a role in prostate cancer. These changes can silence tumour suppressor genes or activate oncogenes, further contributing to the cancerous transformation of prostate cells.

What are the symptoms of prostate cancer?

Prostate cancer often develops slowly, and in its early stages, it may not show any noticeable symptoms. However, as the cancer progresses, it can lead to various symptoms that affect urinary, sexual, and overall physical health. Common symptoms include:

Difficulty starting or stopping urination
Weak or interrupted urine flow
Frequent urge to urinate, especially at night
Blood in the urine or semen
Pain or discomfort in the pelvic area
Erectile dysfunction
Pain in the lower back, hips, or thighs

Who is at risk of bladder cancer in Singapore?

Bladder cancer can affect anyone, but certain factors can increase the likelihood of developing the disease. In Singapore, some common risk factors are linked to lifestyle choices and environmental exposures.

Men over 50

The risk of prostate cancer increases significantly with age, particularly for men over 50.

Family history of prostate cancer

Those with a father, brother, or close relative with prostate cancer are at higher risk.

Genetic predispositions

Men with inherited mutations in BRCA1 or BRCA2 genes, or those with Lynch syndrome, may have an elevated risk.

Lifestyle factors

A diet high in red meats and fats, lack of exercise, and obesity can also increase the risk.

Ethnicity

Research indicates that in Singapore, Chinese men have a relatively higher risk of prostate cancer than Malay or Indian men.

How is prostate cancer diagnosed

At Allen Sim Urology, we employ a thorough and patient-centred approach to diagnosing prostate cancer, using a range of advanced methods to ensure accuracy and early detection. Each diagnostic tool is tailored to provide a comprehensive assessment of prostate health.

01. PSA (Prostate-Specific Antigen) Test

This blood test measures PSA levels, a protein produced by the prostate. Elevated levels may indicate prostate cancer, prompting further examination.

02. Digital Rectal Exam (DRE)

In this physical exam, the doctor feels the prostate through the rectal wall to detect any abnormalities, such as lumps or hardened areas.

03. MRI Scans

Using detailed imaging, an MRI provides a clear view of the prostate, helping to identify suspicious areas that may require further investigation.

04. Prostate biopsy

If needed, a biopsy is conducted to collect small tissue samples from the prostate. These samples are then analysed under a microscope to confirm the presence of cancer cells.

05. Ultrasound-Guided Biopsy

For additional precision, an ultrasound is used to guide the biopsy needle to specific areas of the prostate, improving the accuracy of the diagnosis.

What are the treatment options for prostate cancer in Singapore?

At Allen Sim Urology, our approach focuses on providing personalised treatment options, according to the stage of the cancer, overall health of the patient, and individual preferences. Here are the treatment options we offer:

Monitoring

For low-risk cases, we may recommend close monitoring instead of immediate treatment. Through regular check-ups, PSA tests, and imaging, we carefully track any changes to ensure timely intervention if necessary.

Surgery (Prostatectomy)

When surgery is needed, we perform a prostatectomy, a procedure to remove the prostate gland. This is often recommended for localised cancer, and our surgical techniques focus on precision and reducing recovery time.

Robotic Prostatectomy

This minimally invasive procedure utilises robotic-assisted technology to remove the prostate gland for localised cancer. Since smaller incisions are used, it offers reduced bleeding, lower chances of complications and a faster recovery.

Radiation therapy

For patients who need radiation, we offer external beam radiation or brachytherapy (internal radiation). These treatments aim to target cancer cells while preserving surrounding healthy tissue.

Hormone therapy

Prostate cancer cells often rely on male hormones (androgens) to grow. Hormone therapy works by reducing androgen levels or blocking their effects, slowing cancer growth and providing relief for advanced cases.

Chemotherapy

For cases where the cancer has spread beyond the prostate, chemotherapy may be recommended to kill cancer cells and control symptoms. We guide patients through each stage, ensuring they receive the support they need.

Immunotherapy and targeted therapies

We also explore advanced options like immunotherapy and targeted therapies, which harness the body’s immune system to fight cancer or specifically target cancer cells, offering new hope for more complex cases.

If you are due for a prostate health checkup or experiencing any related symptoms, please schedule an appointment with Allen Sim Urology for a thorough evaluation and expert care.

Frequently Asked Questions (FAQs)

01. How can I reduce my risk of developing prostate cancer?

Adopting a healthy lifestyle can help lower your risk. This includes maintaining a balanced diet rich in fruits and vegetables, engaging in regular physical activity, and avoiding smoking. Regular screenings are also crucial for early detection.

02. What is the survival rate for prostate cancer?

The survival rate depends on the stage at diagnosis. When detected early, prostate cancer has a high survival rate, with many men living for years after treatment.

03. Can prostate cancer affect sexual function?

Yes, prostate cancer and its treatments can impact sexual function, potentially leading to erectile dysfunction. Discussing these concerns with your doctor can help manage and mitigate these effects.

04. How often should I get screened for prostate cancer?

Screening recommendations vary based on age and risk factors. Generally, men over 50 should discuss screening with their doctor, while those with higher risk factors may need to start earlier.

05. Are there any side effects of prostate cancer treatments?

Treatment side effects can include urinary incontinence, bowel issues, and sexual dysfunction. Your healthcare provider will discuss potential side effects based on your specific treatment plan.

06. Can prostate cancer recur after treatment?

Yes, prostate cancer can recur. Regular follow-up appointments and monitoring are essential to detect any recurrence early and manage it promptly.

07. Is it safe to have sex after prostate cancer treatment?

Sexual activity is generally safe after treatment, but you may experience changes in sexual function. Discuss any concerns with your doctor to receive appropriate guidance and support.

08. Are there preventive measures for prostatitis?

While not all cases are preventable, maintaining good hygiene, staying hydrated, practising safe sex, and avoiding prolonged sitting can reduce the risk of developing prostatitis.