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Prostate Cancer

When cells in your body gain the ability to divide uncontrollably, they may form a large mass of tissue known as a tumour. A tumour that forms at the prostate can enlarge it, causing symptoms that are similar to Benign Prostatic Hyperplasia (BPH) (non-cancerous).

Prostate cancer occurs when the cells from a tumour spread to other parts of the body, forming new tumours where it reaches. To determine if the enlarged prostate is cancerous, your doctor will have to perform a PSA blood test and a prostate biopsy.

Prostate Cancer Symptoms

Like many cancers, prostate cancer does not always cause symptoms in its earliest stages. As the tumour grows and narrows the urethra (urine passage), spreading to other organs, the following symptoms may start to show:

  • A weak urine stream
  • Frequent urination
  • Difficulty urinating
  • Pain or burning during urination
  • Blood in urine or semen
  • Painful ejaculation
  • Erectile dysfunction
  • Pain in the back, hips, pelvis, or bones
  • Weight loss or loss of appetite

Causes of Prostate Cancer

Prostate cancer is found mainly in older men above 50 years old. As men age, the prostate naturally changes its size, and damage to the genetic material (DNA) of prostate cells is more likely. The damaged or abnormal prostate cells can begin to grow out of control and form tumours. Whilst age is a well-known risk factor for prostate cancer, smoking and being overweight are more closely linked with dying from prostate cancer.

Those with a family history of prostate cancer are also at higher risk. The age when a close relative was diagnosed is also an important factor.

Prostate Cancer Diagnosis

The prostate specific antigen (PSA) blood test and digital rectal examination (DRE) are two tests that are used to screen for prostate cancer. Screening is recommended if you are a man above 50 years old, especially if you have a family history of prostate cancer. Consult Colin Teo Urology on your suitability for prostate cancer screening.

  • The PSA blood test measures the level of Prostate Specific Antigen in your blood. It is produced only by the prostate and is a normal functioning protein that is important in semen. When its levels are too high, it may suggest the presence of Prostatitis, Benign Prostatic Hyperplasia (BPH), or Prostate Cancer.
  • In a Digital Rectal Examination (DRE), your urologist will examine the prostate by inserting a lubricated, gloved finger into the rectum and feeling your prostate through the rectal wall for lumps or abnormal areas.
  • A Prostate Health Index evaluation may be performed. It is a combination of three blood tests that measure different forms of PSA protein. When reviewed together they may provide a risk assessment for prostate cancer.

If the DRE results are abnormal and your PSA levels are elevated, further testing is conducted to check. The only way prostate cancer can be definitively diagnosed is with a prostate biopsy.

  • In a transrectal ultrasound-guided (TRUS) prostate biopsy, your urologist will obtain tissue samples of your prostate using a thin, hollow needle, guided by an ultrasound or MRI. This is done under local anaesthesia or sedation. The tissue is sent to a pathologist to identify whether the cells are malignant (i.e., cancerous) or benign (i.e., non-cancerous).
  • Another procedure is the MRI fusion prostate biopsy, where you undergo an MRI scan to obtain an MRI image of the area around your prostate. This MRI image will then be overlaid onto the real-time ultrasound scans during the biopsy, allowing your doctor to specifically obtain samples from areas of the prostate that appear abnormal.

Prostate Cancer Treatment Options

If you have low-risk prostate cancer that has not spread, your urologist will keep a close watch with blood tests and exams – the Active Surveillance Protocol.

In higher-risk cancers or more advanced cases, a common surgery to remove the cancerous prostate is the Da Vinci Robotic Assisted Laparoscopic Radical Prostatectomy (RALP). Depending on the patient’s cancer profile, the pelvic lymph nodes around the prostate gland may also be removed. Your surgeon will control a robotic device from a console and perform the procedure through 5 to 6 keyhole-sized incisions in the abdomen. This technique provides more precision, reduces the amount of bleeding and pain, and therefore speeds up recovery time. The precision allows options for bladder neck and nerve-sparing techniques to preserve erectile function and early continence recovery.

Other prostate cancer treatments include:

  • Freezing the cancer cells with cold gas
  • Hormone therapy to stop testosterone from feeding the cancer cells
  • Radiation therapy to kill the cancer cells with powerful beams of energy
  • Chemotherapy, often used for men with prostate cancer that spread to other body parts
  • Immunotherapy, which uses drugs to activate your immune system to fight the cancer

Why should you choose Dr Colin Teo to perform your prostate cancer treatment?

Dr Colin Teo is the Founding Head of Khoo Teck Puat Hospital’s Urology Department, with years of experience in minimally invasive keyhole surgery, operating with precision surgical techniques. Many fellows have trained under his mentorship. He did a Fellowship in EndoLaparoscopy and Andrology at St James’ Hospital in Leeds, UK, and was sponsored for a Senior Healthcare Medical Development Program (HMDP) in Advanced Laparoscopic and Robotic Surgery at University of Southern California (USC) Keck Hospital in Los Angeles, USA.

Seek recommendations on suitable treatment options for Prostate Cancer with Colin Teo Urology. Contact us to book an appointment today.