Prostate cancer is the most common cancer affecting Singapore men (according to statistics from the Singapore Cancer Registry Annual Report 2021).

6 Tips to maintain a healthy prostate

As a start:

  1. Include more green, leafy vegetables in your daily diet. This is a good first step towards a healthy prostate as leafy vegetables contain important vitamins and antioxidants

  2. Avoid charred meats which is associated with a type of chemical (PhIP), which increase the risk of cancer

  3. Get moderate exposure to sunlight. This ensures adequate Vitamin D, which lowers the risk of cancer

  4. Maintain a healthy weight. Being overweight or obese increases risk of prostate cancer.

  5. Exercise regularly. Studies have shown that exercise is beneficial for prostate health

  6. Consider going for prostate cancer screening, if you are above the age of 55. Consult your doctor regarding the pros and cons of going for prostate cancer screening. Prostate health can easily be determined with a digital rectal exam (DRE) and a simple blood test (prostate specific antigen)

Symptoms of prostate cancer

Early prostate cancer is usually asymptomatic. Symptoms of prostate cancer usually show up at later stages of the disease as the tumour grows and narrows the urethra (urine passage) and spreads to other organs.

The following symptoms are non-specific and may also be caused by benign (non-cancerous) conditions such as benign prostatic hyperplasia and prostatitis. They include:

  • Weak or interrupted flow of urine

  • Frequent urination (especially at night)

  • Difficulty urinating

  • Pain or burning during urination

  • Blood in the urine or semen

  • Nagging pain in the back, hips, or pelvis

  • Painful ejaculation

4 Ways prostate cancer is diagnosed

Several abnormal parameters, including clinical findings and laboratory diagnostic tests for cancer, can help to diagnose prostate cancer:

1. ABNORMAL DIGITAL RECTAL EXAMINATION (DRE)

The doctor or nurse examines the prostate by inserting a lubricated, gloved finger into the rectum and feeling the prostate through the rectal wall for lumps or abnormal areas.

2. ELEVATED PROSTATE SPECIFIC ANTIGEN (PSA) LEVEL IN THE BLOOD.

PSA, a substance made by the prostate, may be found in increased amounts in the blood of men who have prostate cancer. PSA levels may also be high in men who have an infection, inflammation or an enlarged non-cancerous gland.

3. TRANSRECTAL OR TRANSPERINEAL ULTRASOUND GUIDED BIOPSY OF THE PROSTATE SHOWING THE PRESENCE OF CANCER CELLS

This is a procedure in which an ultrasound probe about the size of a finger is inserted into the rectum to check the prostate. The probe is used to bounce high-energy sound waves (ultrasound) off internal tissues and make echoes. Cells are removed by a thin needle under a local anaesthetic and viewed under a microscope by a pathologist.

4. MRI OF THE PELVIS

This is a detailed scan of the pelvis that helps to identify the extent of cancer involvement in the prostate gland or surrounding lymph nodes. A MRI scan may be performed either before or after biopsy confirmation of cancer.

Treating prostate cancer with SBRT (stereotactic body radiotherapy)

If you are diagnosed with early stage prostate cancer, you may be eligible for stereotactic body radiotherapy (SBRT) treatment.

Compared to traditional radiotherapy that requires daily treatments of between 37 to 39 sessions, which can last up to two months, SBRT delivers radiation over a much shorter period (2-3 times shorter) and can be completed within five sessions. This enables patients to return back to work and normal activities more quickly (in nearly half the time).

“This is due to improvement in technology that allows for better imaging of the prostate, faster and more precise radiation delivery,” said Dr Li Youquan, Consultant from the Division of Radiation Oncology at National Cancer Centre Singapore (NCCS), a member of the SingHealth group.

Recent studies also confirmed that SBRT is as effective as traditional techniques with a promise of reduced side effects such as rectal bleeding and sexual dysfunction1.

Since 2014, over 100 patients from NCCS have been treated with SBRT with good clinical outcomes and a favorable toxicity profile. The treatment is currently being tested in two large randomised control trials in the United States and United Kingdom and could replace traditional treatments as the new standard2,3.

References:

  1. Cushman TR et al, Oncotarget. 2019 Sep 24; 10 (54) 5660-5668
  2. PACE-B trial (NCT01584258)
  3. NRG GU005 (NCT03367702)

Ref: K21

Check out our other articles on prostate cancer:

Prostate Cancer: What You Need to Know

Prostate Cancer Treatment: How to Choose the One That's Right for You

Prostate Cancer: Overview On Treatment Options

Prostate Cancer - Doctor Q&A