Prostate Cancer
Learn more about prostate cancer - what it is, its types, common signs and symptoms, treatments, and others.
What Is Prostate Cancer?
Prostate cancer is a prevalent form of cancer that affects the prostate gland, a small, walnut-shaped gland located beneath the bladder and is found exclusively in males. The prostate is primarily responsible for the production of seminal fluid which nourishes, and transports sperms and its development depends on testosterone, a male sex hormone.
Prostate cancer happens when a malignant tumour is formed in the prostate gland due to an uncontrollable division of cancer cells. Sometimes, the cancer can spread to other parts of the body such as the bones and lymph nodes through the lymphatic system. It can also spread to other parts of the body such as the pelvis or to the backbone. This form of cancer is aggressive and is potentially a life limiting condition.
Types Of Prostate Cancer
The different types of prostate cancers are categorized depending on where the cancer started.
- Acinar adenocarcinoma: Adenocarcinoma makes up 95% of all prostate carcinoma. The Acinar subtype is predominant. It originates and develops in gland cells that make prostate fluid.
Other less common types of prostate cancer includes:
- Ductal adenocarcinoma.
- Transitional cell carcinoma.
- Neuroendocrine tumours.
- Squamous cell carcinoma.
- Small cell carcinoma.
- Prostate sarcoma.
Common Symptoms Of Prostate Cancer
The symptoms of prostate cancer might not show in the early stages. Most patients with early-stage prostate cancers in fact do not experience any symptoms. Typically, any symptoms may be quite common and can be related to other illnesses. However, doctors recommend men to look out for the following warning flags which may indicate the presence of prostate cancer. This is especially if there is recent onset of symptoms, or there is worsening or pre-existing symptoms.
The common symptoms of prostate cancer includes:
- Difficulty in urinating, including a slow or decreased force in the stream of urine.
- Frequent and/or urgent urination, especially at night (Nocturia).
- Trouble getting an erection (Erectile dysfunction, also known as ED).
- Unexplained weight loss and loss of appetite.
- Bone pain (due to cancer spreading to bones).
- Lower limbs feeling weak.
- Lower limbs swollen.
It is to note that most of these symptoms are more likely to be caused by other conditions than prostate cancer. For example, difficulty urinating is much more often caused by benign prostatic hyperplasia (BPH), a non-cancerous growth of the prostate. Some of these symptoms might also be caused by other more common conditions such as Urinary Tract Infection (UTI) or Urinary stones. However, if a male individual has a couple of the above symptoms even to a mild degree, then it is still recommended that he gets checked for prostate cancer as in majority of cases prostate cancer is not diagnosed until the cancer has spread. This can substantially compromise the overall prognosis for the patient.
Prostate Cancer In Singapore
In Singapore, prostate cancer is the top 1 or the most common cancer among men. According to the latest Singapore Cancer Registry Annual Report, it is also the fifth biggest cause of cancer-related mortality among males, making up to 6.7% of cancer deaths.
Prostate Cancer Screening
Screening aims to detect prostate cancer in its early stages when treatment is most effective. Common screening methods include:
- Prostate-Specific Antigen (PSA) Test – Measures the levels of PSA, a protein produced by the prostate. Elevated PSA levels may indicate the presence of prostate cancer, though other factors can contribute to increased PSA levels.
- Digital Rectal Examination (DRE) – Involves a physical examination of the prostate through the rectum to detect abnormalities in the gland’s texture or shape.
Book A Prostate Cancer Screening In Singapore
Health365 in partnership with trusted healthcare providers in Singapore offers health screening packages including PSA test for prostate cancer screening. Check for health screening options below.
Prostate Cancer Treatment Options
The choice of treatment for prostate cancer depends on various factors, including the cancer’s stage, grade, and the patient’s overall health. Common treatment options include:
- Active Surveillance – Active surveillance refers to a protocol of closely observing patients with low-risk localized prostate cancer while keeping the option of deferred curative treatment open.
- Watchful Waiting – Watchful waiting may be an option for elderly men and those with other serious or life-threatening illnesses who are expected to live less than 5 years. Watchful waiting involves a less intensive follow-up compared to active surveillance. If the cancer is found to be worsening or showing symptoms such as pain or blockage of the urinary tract, then treatment may be recommended.
- Surgery (Prostatectomy) – Surgery involves the removal of the prostate including some surrounding tissue and a few lymph nodes. This is a common treatment for localised prostate cancer. There are two options, open or laparoscopic surgery.
- Radiation Therapy – Radiation therapy uses high-energy beams to kill cancer cells or prevent their growth. Some main forms of radiotherapy used are External Beam Radiotherapy (EBRT) and Brachytherapy which involves the surgical placement of permanent or temporary implants to deliver radiation to the prostate.
- Chemotherapy – Chemotherapy drugs attack rapidly dividing prostate cancer cells and have been shown to help prostate cancer patients live longer. Drugs are typically administered as infusion in outpatient.
- Immunotherapy – Cancer cells can turn off ‘checkpoint proteins’ to prevent the immune system from attacking them. Drugs called checkpoint inhibitors can be used for people whose prostate cancer cells have tested positive for specific gene changes, such as a high level of microsatellite instability (MSI-H), or changes in one of the mismatch repair (MMR) genes.
- Proton Beam Therapy – Proton beam therapy is a type of external beam radiation therapy that uses protons instead of traditional X-rays to deliver radiation to the cancerous cells. Protons have unique properties that allow for precise targeting of the tumour while minimising damage to surrounding healthy tissues.
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