Prostate Cancer

Introduction

Prostate cancer is the second most common cancer in men worldwide, after lung cancer.

The most common type of prostate cancer is adenocarcinoma. Very rarely, prostate cancer can arise from other cell types such as neuroendocrine, sarcoma, small cell or transitional cell. This rest of this article pertains to the most common adenocarcinoma type.

It is also not to be confused with Benign Prostatic Hyperplasia (BPH) which is enlargement of the prostate gland in men as they get older. It is not cancerous. However, its signs and symptoms may be similar to prostate cancer.

Symptoms

Different individuals may present with different symptoms and not all symptoms in the list will affect every individual. Some of these may include:

  • Difficulty passing urine
  • Hesitancy in starting urination
  • Urinary incontinence/ unable to control or hold back
  • Weak urine flow or dribbling
  • Incomplete bladder emptying
  • Blood in the urine or semen
  • Erectile dysfunction
  • Continual pain in the lower back, pelvis, hips or thighs
  • Pain in bony areas especially spine or hips (if cancer has spread to bones)

These symptoms are not specific and may also be caused by a variety of other reasons. Rather, it is the constellation of symptoms that your doctor will assess before planning further investigations. It will be best to speak to your doctor if you are concerned with any of these.

Diagnosis

Early and rapid diagnosis is vital because the sooner you can be treated, the better the chance to kill the cancer before it gets larger or spread further. Typically this will involve a number of tests which can be arranged together to ensure treatment can be started as soon as possible once the diagnosis is confirmed.

A simple digital rectal examination may allow your doctor to detect some of the abnormal nodules in the prostate. If there is any suspicion for cancer, additional imaging may be done such as an MRI or PET scan. These will also allow proper staging of the cancer. A biopsy will be needed to confirm the diagnosis and often may done under ultrasound guidance.

Treatment Options

The latest advances in treatment of prostate cancer especially in advanced disease has enabled the prolongation of life, and more importantly maintain the quality of life while undergoing treatment. We will discuss the best options available based on the staging of the cancer with every individual. No two cancers are the same and no two individuals are the same. Therefore the treatment should also be highly personalized.

We work closely with other specialists who are expert in their fields to offer the following modalities of treatment based on the staging of cancer: Surgery, radiotherapy, hormonal therapy, chemotherapy and bone-targeted therapy.

The choice and sequence of the therapies will be planned at the outset to ensure the best outcome for your prostate cancer.

Prevention and Screening

Screening for prostate cancer remains very controversial. This involves the measurement of PSA levels in the blood. On one hand it may lead to earlier detection of prostate cancer. On the other hand, one may argue that the cancer may grow so slowly that it may never present problem in the entire lifetime of the individual. There are various other factors to be taken into account when interpreting a PSA results. It is best to speak to your doctor should you have any concern about testing.

The cause of prostate cancer remains unknown thus far. Increasing age is a major risk factor which cannot be controlled. Dietary studies have not been able to prove any association between specific food group and prostate cancer. However, leading a healthy lifestyle is still advisable which benefits health immensely and may help lower risks for other cancers.

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