Prostate Cancer Treatment in Singapore

Prostate cancer develops in the prostate gland, a small organ below the bladder that produces seminal fluid. It typically grows slowly and remains confined to the prostate, causing little harm. However, some forms can be aggressive and spread quickly. One of the most common cancers in men, particularly those over 50, it can be life-threatening, but most cases are manageable due to slow progression and effective early treatment.

Dr. Lie Kwok Ying

Medical Council Certified Urological Specialist

BA MBBChir (Cantab)|MRCS (Edin)|FRCS (Urol)(Glasg)|FAMS

Symptoms Causes Diagnosis Treatment Prevention FAQ

Symptoms of Prostate Cancer

Men with early-stage prostate cancer may have no noticeable symptoms, while advanced disease can cause several distinctive signs.

Urinary difficulties: Weak or interrupted urine flow, frequent urination (especially at night), and difficulty starting or stopping urination. These occur as the growing tumour presses on the urethra and bladder.
Blood in urine or semen: This may indicate prostate abnormalities caused by cancer damaging blood vessels within the prostate or surrounding tissues.
Erectile dysfunction: Some men develop erectile problems as cancer affects the nerves and blood vessels essential for normal function, typically in later stages.
Pain or discomfort: Discomfort in the pelvic area, lower back, hips, or thighs may signal advanced disease where cancer has spread beyond the prostate.
Bone pain: Persistent pain in bones, particularly the spine, hips, and ribs, may indicate metastatic prostate cancer, as it commonly spreads to bones.

Prostate Cancer Causes and Risk Factors

Prostate cancer develops when cells in the prostate gland undergo genetic changes. Common risk factors include:

Age

The risk increases significantly after age 50, with most cases diagnosed in men over 65.
Family history

Men with close relatives (father or brother) who have had prostate cancer face a higher risk. Having multiple affected relatives further increases this risk, indicating a genetic component.
Genetic mutations

Mutations in genes like BRCA1, BRCA2, or those linked to Lynch syndrome increase prostate cancer risk by affecting cell growth and division.
Diet and lifestyle

Diets high in fat, particularly from red meat and dairy, may increase risk, while obesity is linked to more aggressive forms. Regular physical activity appears to have a protective effect.
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Diagnostic Methods of Prostate Cancer

Prostate-specific antigen (PSA) test: A blood test that measures PSA levels, a protein produced by the prostate gland. Elevated levels may indicate prostate cancer, though benign conditions like prostatitis or benign prostatic hyperplasia can also cause high readings. It serves as an initial screening tool, with values over 4 ng/mL typically requiring further investigation, though age-specific reference ranges may apply.
Digital rectal examination (DRE): A urologist in singapore inserts a gloved, lubricated finger into the rectum to assess the prostate for abnormalities. This helps evaluate prostate size, consistency, and the presence of nodules or hard areas, detecting tumours that other tests may miss.
Prostate biopsy: Small tissue samples are extracted from the prostate using thin needles, typically guided by transrectal ultrasound. The samples are examined under a microscope to confirm cancer and determine its grade (Gleason score). Multiple cores are taken to improve detection accuracy.
Imaging studies: Various imaging techniques assess the prostate and detect cancer spread. MRI provides detailed prostate images and identifies suspicious areas for targeted biopsy. Bone scans, CT scans, and PET scans help determine if cancer has metastasised to lymph nodes, bones, or other organs.

Prostate Cancer Treatment Options

Treatment for prostate cancer depends on disease stage, patient age, overall health, and individual preferences. The primary treatment options include:

Non-Surgical Treatment

Active surveillance: Recommended for low-risk, slow-growing prostate cancer. Regular PSA tests, DREs, and periodic biopsies monitor progression, allowing treatment if needed while avoiding unnecessary side effects.
Hormone therapy (androgen deprivation therapy): Reduces testosterone levels to slow cancer growth. Options include medications that suppress testosterone production or block its action, as well as surgical removal of the testicles (orchiectomy).
Cryotherapy: A minimally invasive procedure using extreme cold to freeze and destroy cancer cells. Guided by ultrasound, thin needles deliver freezing gases to the prostate, forming ice balls that kill cancerous tissue. It may be a primary treatment or used for recurrent cancer after radiation therapy.

Surgical Treatment

Radical prostatectomy: A surgical procedure that removes the entire prostate gland along with surrounding tissues, including the seminal vesicles and, in some cases, nearby lymph nodes. This procedure can be performed through open surgery, laparoscopic surgery, or robot-assisted techniques, with the latter offering greater precision and potentially faster recovery. When feasible, nerve-sparing approaches are used to help preserve urinary control and erectile function, improving post-surgical quality of life.

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Prevention and Management

While prostate cancer cannot be fully prevented, certain lifestyle measures may reduce risk and improve outcomes. Maintaining a healthy weight, exercising regularly, and following a balanced diet rich in fruits, vegetables, and whole grains while limiting red meat may help lower risk. Men with a family history or genetic risk should discuss screening with their doctor. For those diagnosed, management includes regular PSA tests, adherence to treatment, and addressing side effects. Men who are also exploring options related to enlarged prostate treatment in Singapore may benefit from early consultation to understand their overall prostate health.

Frequently Asked Questions

How often should men be screened for prostate cancer?

Screening depends on risk factors. Men at average risk may start at 50, while higher-risk individuals or those with a family history may begin at 45. PSA testing and possibly DRE are done annually or less often based on risk and prior results.

Can prostate cancer spread to other parts of the body?

Yes, advanced prostate cancer can metastasise, commonly to bones, lymph nodes, lungs, or the liver, leading to symptoms like bone pain and weight loss.

Can prostate cancer return after treatment?

Yes, prostate cancer can recur even after successful treatment. Regular PSA monitoring helps detect recurrence early, as rising PSA levels can indicate cancer return before symptoms appear.

Dr. Lie Kwok Ying

Senior Consultant Urologist in Singapore

BA MB BChir (Cantab)|MRCS (Edin)|MMEd (Surg)|FRCS (Glasg)(Urol)|FAMS

Dr. Lie Kwok Ying is a Senior Consultant Urologist and pioneered the use of HoLEP (Holmium Enucleation of Prostate) for benign prostatic hyperplasia (BPH) in Singapore.

He graduated from Queens’ College in Cambridge University with triple First Class Honours and subsequently qualified in 2001 with degrees in Medicine and Surgery.

Clinical Interests in Urology