Prostate cancer is a disease where malignant (cancer) cells form in the prostate tissue. It is the third most common cancer in Singapore men and the most common cancer in American men.

Risk factors of prostate cancer

Prostate cancer is mainly found in older men above the age of 50. Those with a family history of prostate cancer are at slightly higher risk.

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

Diagnosis of prostate cancer

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.

Read on to learn about the different treatment options for prostate cancer.

Ref: Q15