Prostate cancer is the second most commonly diagnosed cancer and the fourth most common cause of cancer death for men in Singapore. While this may sound alarming, survival rates of prostate cancer are high at 87.8% from 2015 to 2019. Still, it’s important to note that the proportion of early diagnosis of prostate cancer fell from 63.5% to 51.7% in 2013 to 2017, highlighting the need for men to proactively take charge of their prostate health and go for screening checks.
National Cancer Centre Singapore oncologist, Assoc Prof Ravindran Kanesvaran, encourages prostate cancer screening for men above the age of 50.
What is prostate cancer?
The prostate gland is the part of the male reproductive system that produces seminal fluid and transports sperm. Prostate cancer develops when abnormal cells in the prostate multiply too quickly and become malignant and cancerous. In general, prostate cancer tends to be slow growing compared to other types of cancer. When prostate cancer is detected early and still confined to the prostate gland, the chances for positive outcomes are higher.
Who’s at risk for prostate cancer?
A number of different factors contributes to an increased risk of developing cancer. The risk increases with age, usually occurring in men over the age of 50, and is most commonly seen in those over the age of 70.
In Singapore, Chinese men are at higher risk for developing prostate cancer compared to Malay or Indian men. Having family members with prostate cancer also increases a man’s chance of getting it. Additionally, if a man carries a mutated BRCA1 or BRCA2 gene, associated with an increased chance of breast cancer in women, they may have a more aggressive form of prostate cancer.
Certain lifestyle factors such as consuming a high fat diet, particularly from animal sources such as dairy products and red meat, and processed food, also increases the risk of developing prostate cancer.
Prevention and spotting the signs
Adopting a healthy lifestyle is one way to mitigate the risk of developing prostate cancer. This includes consuming a low-fat diet that includes plenty of leafy, green vegetables and getting regular exercise.
It is difficult to spot prostate cancer early because there are typically no symptoms. Symptoms are usually a sign of advanced disease that has spread from the prostate to other organs. They include an increase in urination frequency, weak or interrupted urine flow, blood in the urine or semen, pain when urinating and constant lower back pain. If a man displays any of these symptoms and is concerned he should consult a primary care physician.
Screening for prostate cancer
As there are few signs of early prostate cancer, it’s important for men over the age of 50 to consult their doctor about the pros and cons of prostate cancer screening.
Screening for prostate cancer consists of two parts - a digital rectal examination and a blood test that measures Prostate-Specific Antigen (PSA) levels in the blood. An elevated PSA level may indicate the presence of prostate cancer.
After a blood test detects elevated PSA levels, a biopsy can confirm the presence of prostate cancer. A biopsy takes samples of the prostate tissue for further examination and is often accompanied by an ultrasound scan or MRI guided scan, that allows the doctor to see where to take small samples of tissue from.
Finally, a MRI of the pelvis is also used to determine the extent of the cancer spread in the prostate and the surrounding lymph nodes.
Treating prostate cancer
The treatment of prostate cancer varies and is dependent on the extent and spread of a patient’s cancer, their age, existing medical conditions and test results. The multiple approaches include active surveillance for those with early stage disease while surgery, hormone therapy, radiotherapy and chemotherapy are among the different methods used to treat more advanced prostate cancer.
The goal for optimal health for older men remains prevention and early detection of prostate cancer. The earlier prostate cancer is detected, the easier it is to treat. So, men above the age of 50 who experience symptoms or have a family history of prostate cancer are encouraged to be brave and take charge of their prostate health by getting screened for prostate cancer.
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