Prostate cancer is cancer that develops in the cells of the prostate, a gland in the male reproductive tract located below the bladder and in front of the rectum. Prostate cancer occurs when cells in the prostate develop abnormally and become cancerous.
Prostate cancer is common, and usually occurs in men over the age of 50, although it can sometimes occur in younger patients. It is often diagnosed in the early-stage where it is confined to the prostate gland, although more aggressive forms of the disease are sometimes diagnosed in later stages.
The most common type of prostate cancer is Adenocarcinoma, less common subtypes include neuroendocrine carcinomas, transitional cell carcinomas and sarcomas.
There are usually no symptoms in the early stages of prostate cancer. As most prostate cancers are slow growing, many men reach old age or pass away without knowing that they have prostate cancer. Most men discover they have prostate cancer during routine medical check-ups or through blood tests.
The symptoms mentioned above should not be ignored, although they can be caused by a number of other reasons. There are several conditions that can present with symptoms similar to prostate cancer such as benign prostatic hyperplasia, urinary tract infections (UTIs) or kidney stones. You should make an appointment with your doctor if you experience any signs or symptoms that worry you.
There are no proven preventive strategies for prostate cancer. And at present, there is a lack of evidence to support population-based screening for prostate cancer in Singapore. However, adopting a healthy lifestyle can help prevent the risk of prostate cancer. This includes:
While it is not clear what causes prostate cancer, there are certain risk factors including age, family history of prostate cancer, obesity and ethnicity. In Singapore, Chinese men have double the risk of getting prostate cancer compared to Malay or Indian men.
Some of the risk factors that are known to increase the risk of developing prostate cancer are:
Several different tests can be used to diagnose prostate cancer, including:
Treatment for prostate cancer depends on several factors including the patient’s age, medical conditions, significant illnesses, prostate-specific antigen level, digital rectal examination results, aggressiveness of the cancer and spread of disease.
An individual with prostate cancer should be assessed by a multi-disciplinary team of specialists to determine which modality of treatment is best for them. Prostate cancer treatment requires the involvement of different specialists – urologists, interventional radiologists, nuclear medicine physicians, medical oncologists, radiation oncologists and palliative medicine specialists. Such multi-disciplinary care is available at SingHealth healthcare institutions. It is important to discuss all the possible treatment choices, including what to expect and possible side effects, to help you make an informed decision.
Your urologist will perform a comprehensive medical workup including blood tests, exams and scans to see if you are suitable for surgery and advise you on the risks involved. This treatment recommendation is often based on consensus by a group of different specialists (tumour board) which weighs the pros and cons of every treatment strategy.
Before surgery, the anaesthesia team will also assess your fitness for surgery and advise you on various aspects of general anaesthesia and pain control after surgery. Specialist nurses will also provide pre-surgery counselling.
After recovering from surgery, you will be given regular outpatient appointments to see your team of doctors. These visits may include blood tests and scans to monitor and check if prostate cancer recurs.
It is important to follow your doctor's advice, keep to scheduled clinic visits and do the prescribed tests so that timely treatment can be administered if prostate cancer or other problems arise.
Prostate cancer can be treated successfully especially when detected early. The likelihood of a cure depends on several factors, including the stage of the cancer, how aggressive the cancer is, how far it has spread, and the patient’s overall health and response to treatment.
The life expectancy for someone diagnosed with prostate cancer varies based on several factors, including the stage of cancer at diagnosis, the specific type of prostate cancer, the patient's overall health, and how well the cancer responds to treatment.
General statistics indicate that for early-stage prostate cancer, the estimated 5-year survival rate is more than 90%. Many people with early-stage prostate cancer can be effectively treated and remain cancer-free.
For more advanced stages of prostate cancer, the 5-year survival rate is about 30% to 50%, depending on how aggressive the cancer is, how far it has spread, and the patient’s overall health and response to treatment.
While stage 4 prostate cancer is not considered curable, it is still a highly treatable disease. It is best for patients to have a discussion with their treating doctor on management strategies.
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