As men enter their 60s and beyond, understanding the prostate becomes key to staying healthy and living life to the fullest.
As men age, prostate health becomes increasingly important. Conditions like benign prostate hyperplasia (BPH), also known as an enlarged prostate, and prostate cancer are common — but with the right knowledge and early detection, they can be effectively managed.
Dr Alvin Lee, Associate Consultant from the Department of Urology at Singapore General Hospital (SGH), a member of the SingHealth Group, simplifies it for you.
What does the prostate do?
The prostate is a small gland located below the bladder. It plays a key role in the male reproductive system by producing fluid that nourishes and transports sperm.
"Its (the prostate's) main job is to produce about 25-30% of the fluid that makes up semen. Sperm come from the testicles; the prostate adds a special "sauce" – a milky, slightly alkaline fluid packed with nutrients, enzymes and zinc. This fluid protects sperm, helps them swim better, and keeps semen liquid so it can travel through the female reproductive tract.
The prostate also has small muscles that contract during ejaculation to help push semen out forcefully. Think of it (the prostate) as the quality-control and delivery department for sperm. Without it, fertility would be much harder," explained Dr Lee.
How the prostate changes with age
As men get older, the prostate often enlarges naturally. This can lead to:
- Urinary symptoms (e.g. weak stream, frequent urination)
- Increased risk of prostate conditions
Common prostate conditions include:
- Benign Prostate Hyperplasia (BPH) – non-cancerous enlargement
- Prostatitis – inflammation of the prostate
- Prostate cancer
What are symptoms of prostate problems?
Early prostate cancer may not cause noticeable symptoms. When symptoms do appear, they may include:
- Difficulty starting or stopping urination
- Weak urine flow
- Frequent urination, especially at night
- Blood in urine or semen
- Pain in the back, hips or pelvis
However, these symptoms can also be caused by non-cancerous conditions like BPH, so proper evaluation is important.
What is a PSA test?
The Prostate-Specific Antigen (PSA) test is a blood test used to detect prostate abnormalities.
Important things to know about PSA
- PSA is organ-specific, not cancer-specific
- Elevated PSA levels can be caused by:
- Prostate cancer
- BPH
- Prostatitis
- Recent ejaculation or medical procedures
There is no single PSA level that completely rules out cancer, so results must be interpreted together with other tests.
What happens if PSA is high?
If PSA levels are elevated or a digital rectal exam (DRE) is abnormal, further tests may be done:
- MRI scan (multiparametric MRI) to identify suspicious areas
- Prostate biopsy to confirm diagnosis
Modern biopsy techniques now use advanced imaging and precision tools to improve accuracy.
What is benign prostate hyperplasia (BPH), also known as an enlarged prostate?
Benign prostate hyperplasia (BPH), also known as an enlarged prostate, is a non-cancerous enlargement of the prostate that can affect urination.
How to manage BPH
How to treat BPH
Treatment options include:
- Medications
- Minimally invasive procedures (e.g. Rezum, UroLift, iTIND)
What is prostate cancer?
Prostate cancer occurs when abnormal cells grow in the prostate gland. It is one of the most common cancers in men in Singapore.
Some prostate cancers grow slowly and may not cause symptoms early on, while others can be more aggressive.
How is prostate cancer diagnosed?
Diagnosis typically involves:
- PSA testing
- Digital rectal examination (DRE)
- MRI imaging
- Biopsy (tissue sampling)
Cancer grading (e.g. Gleason score) helps determine how aggressive the cancer is and guides treatment decisions.
Prostate cancer treatment: What are the options?
Treatment depends on the stage and aggressiveness of the cancer.
1. Active surveillance
For slow-growing cancers, doctors may recommend monitoring without immediate treatment.
2. Surgery
Removal of the prostate (prostatectomy) may be recommended for certain cases.
3. Radiotherapy
Modern radiotherapy is highly targeted, reducing damage to surrounding tissues and lowering side effects.
4. Hormone therapy
Used to reduce testosterone levels that fuel cancer growth.
Newer treatments with fewer side effects
Advances in prostate cancer care have significantly improved quality of life:
- More precise radiotherapy techniques
- Minimally invasive surgery
- Better preservation of urinary and sexual function
These improvements mean many men can continue to lead active, fulfilling lives during and after treatment.
What you can do to protect your prostate health
While not all prostate conditions are preventable, you can reduce risk by:
- Maintaining a healthy weight
- Exercising regularly
- Eating a balanced diet
- Going for regular health screenings
- Speaking to your doctor about PSA testing
When to see a doctor for a prostate problem
Seek medical advice if you experience:
- Persistent urinary symptoms
- Blood in urine or semen
- Unexplained pain in the lower back or pelvis
- Sudden changes in urinary habits
A positive outlook for men’s health
Prostate conditions are common, but they are also highly manageable when detected early. With better screening tools and more advanced treatments today, men have more options than ever to protect their health and maintain quality of life.
Taking that first step — whether it’s learning about your risk or going for a check-up — can make all the difference.
Ref: F26
Related articles:
Benign Prostatic Hyperplasia (Enlarged Prostate): What to Do
Stay Healthy the Easy Way
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