Editor's Note

Prostate cancer is now the fifth most common cancer in Singaporean men. The incidence has been increasing over the last 35 years affecting mostly men after the age of 50 years. The latest reported figures from the Singapore Cancer Registry shows an increase of 4 times comparing 1998-2002 to the period 1968-1972. It is the third most common cancer in Malay and Indian men. Our thinking about prostate cancer has changed over the years. Often thought of as a disease of older men who die with the disease rather than of the disease, there are clearly some men who have prostate cancer younger and some who have a more aggressive course.

Often thought of as a hormonal responsive disease, there is also clearly an entity called "hormone refractory prostate cancer" (HRPC) whereby cancer cells do not respond to hormonal manipulation anymore. In these situations, chemotherapy which kills the prostate cancer cells via a non-hormonal route is potentially useful. It has taken many years for the trial information to show that chemotherapy does have an important role, improving survival in prostate cancer patients. Of course, chemotherapy should ideally be given when patients have failed to respond to hormones and are still fit. In HRPC, ineffective hormonal therapy may delay a patient receiving chemotherapy until they are weak and frail and so they should be considered early once HRPC is diagnosed.

Our issue also covers tips on managing side effects of prostate cancer treatment and a cancer survivor's personal encounter with God. To highlight the support group program at the National Cancer Centre, we also show you a couple support session conducted by our Psychosocial Oncology team. Visit the "Virgin Island" and see how imagery is used in support counselling programs.

Dr Peter Ang