What You Need to Know About Prostate Cancer
Prostate Cancer is the third most common cancer in Singaporean men. With such an alarming statistic, Dr Sam Peh Oon Hui, urologist in Singapore sets out to highlight the important frequently asked questions about this disease and its management.
What is prostate cancer and who will be at risk?
A healthy human prostate is classically said be slightly larger than a walnut. In actuality, it approximately the size of a kiwifruit situated below the urinary bladder. Only men have prostate the function of the prostate gland is to produce the liquid that sperm swim in. The combination of both is called semen and this is what a man ejaculates.
Prostate cancer is the uncontrolled growth of prostate glandular cells and this occurs in men who are usually over 50 years of age. When cancer develops in the prostate, it may spread through the lymphatic and venous systems to other parts of the body such as the bones and lungs.
What are the symptoms and when should I see a doctor?
Early prostate cancer does not usually have symptoms. In advance prostate cancer, patients can have blood in urine, urinary obstruction, loss of weight and bone pain. Men should have their Prostate-Specific Antigen (IPSA) tested after the age of 50. If there is a family history of prostate cancer then they should have their PSA tested at the age of 40 years old.
How is PSA tested?
PSA is a blood test done for detecting prostate cancer. Elevated PSA does not mean that a man definitely has cancer of the prostate. Broadly, the understanding is that higher the PSA count, the higher the probability of having cancer in the prostate. It must be qualified that here are other causes of high PSA like Benign prostate hyperplasia and prostate infection. The actual test is done using a special kit but PSA test alone cannot diagnose cancer of the prostate.
What is the difference between Benign Prostate Hyperplasia and prostate cancer?
Benign prostate hyperplasia (BPH) also affects older men. The prostate enlarges but there is no cancer in the prostate. It is more common and causes urinary symptoms like waking up at night to pass urine, slow urinary stream, frequent urination and urgency to pass urine. If you think that you are suffering from BHP, you should see a doctor to assess the severity of the BPH and also rule out cancer the prostate.
Are there any treatments for prostate cancer?
Treatment of prostate cancer can be divided into:
i) Cancer that is still within the prostate (early prostate cancer) and;
ii) those whose cancer has spread beyond the prostate.
The treatments for early prostate cancer include surgery and radiation therapy. In advance prostate cancer, the treatment is usually hormone therapy.
Hormone therapy is used for advance age prostate cancer treatment. How is this carried out?
Hormone treatment for advanced prostate cancer is based on the cancer cells of testosterone. The first and obvious way was to remove the testes surgically, then being the source at most male hormones in the body. This method was performed for many years but was attractive for obvious reasons.
Now we give Luteinising Hormone-Releasing Hormone (LHRH) against injections once every three months and this effectively suppresses the production of testosterone, LHRH hormone that stimulates testes to produce testosterone. With LHRH agonist, it initially increases he stimulation of testes but subsequently the LHRH levels drops and so does the production of testosterone by the testes. In cases where the tumour is not controlled by this method, additional oral medication can be givn to block the testosterone receptors on the cancer cells.
How can I prevent prostate cancer?
Prostate cancer is more common in Western or economically advanced counties. This is partly due to the higher fat content of the populations diet. A diet low in animal fat can reduce the risk of cancer the prostate, as well as cessation of smoking. Men should also have the PSA tested as suggested above because early prostate cancer is potentially curable.
Listen to Dr. Sam Peh’s Radio Interview: Prostate Checkups & Treatments.
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