Author: Dr Poh

Prostate cancer is the most common cancer in men. Most prostate cancers are slow-growing but some prostate cancers are aggressive. Increasing age is the most important risk factor for developing prostate cancer. However, a small number of cases can happen to men below the age of 65.

The prostate gland and age-related changes

The prostate is located between the bladder and the penis, measuring about the size of a walnut. Its main function is to secrete prostatatic fluid, one of the components of semen. Enlargement of the prostate is called benign prostatic hyperplasia (BPH) and is common in men above the age of 50.

Benign Prostatic Hyperplasia (BPH)

BPH is not cancer and is considered part of normal age-related changes. It does not increase the risk of cancer but it could produce symptoms that can affect your quality of life.

These symptoms include

• Incomplete bladder emptying
• Nocturia, which is the need to urinate two or more times per night
• Trouble urinating
• Discomfort in the pelvic area
• Painful urination
• Blood in the semen or urine

BPH and prostate cancer have similar symptoms, so it’s sometimes hard to tell the two conditions apart. Make an appointment with your doctor if you have any signs or symptoms that worry you.

Prostate Cancer: How do you tell it apart from BPH

Prostate cancer begins when some cells in your prostate become abnormal. The abnormal cells accumulate and multiple to form a tumor that can grow to invade nearby tissue. Some abnormal cells can also spread (metastasize) to other parts of the body. Hence, prostate cancer that’s detected early has a better chance of successful treatment.

When you first have symptoms, your doctor will arrange for a Prostate-specific antigen (PSA) test. This is a blood to detect a protein your prostate gland makes which can be high when your prostate grows. It can’t tell for sure that you have BPH or prostate cancer. Your doctor may also examine your recturm with his/her finger to check if your prostate is enlarged.

If abnormalities are found and there is suspicion of possible cancer, you will need to be referred to a specialist where a biopsy can be done, which removes a sample of prostate tissue and checks it under a microscope for cancer.

Imaging such as ultrasound and MRI can be useful to assess the prostate gland.

Is there a cure?

The curative treatment for prostate cancer depends on the stage of the disease. In most cases, if there is no spread, curative treatments for prostate cancer include:

• Active surveillance or watchful waiting: Your doctor watches your symptoms or does regular DRE and/or PSA tests to check for cancer growth. Many people die with prostate cancer instead of prostate cancer. Hence no treatment is needed in some cases.
• Surgery: A procedure called a radical prostatectomy removes the prostate gland and some of the tissue around it.
• Radiation therapy: Radiation uses high-energy X-rays to destroy prostate cancer. It can be done with a radiation beam or you can get it through small radioactive pellets or seeds placed inside your prostate.
• Cryotherapy: This treatment uses intense cold to destroy prostate tissue. Freezing often damages the nerves near the prostate that control erections and can cause erectile dysfunction after treatment.
• Hormone therapy: You take medicine to block the male hormones that fuel the growth of prostate cancer.

When treated, the five-year survival rate for all stages of prostate cancer is almost 100 percent compared to men without this cancer.

How are my symptoms treated?

Symptomatic treatment for prostate cancer is similar to BPH.

Alpha-blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), and tamsulosin (Flomax) relax muscles in your bladder and prostate to help you urinate more easily.

5-alpha reductase inhibitors, such as dutasteride (Avodart) and finasteride (Proscar), shrink your prostate.

How can I prevent prostate cancer?

If you’ve already been diagnosed with BPH or prostate cancer, see your doctor for regular follow-ups. Routine screening isn’t recommended for prostate cancer, you might want to get screened with a DRE or PSA test based on your age and risks. Ask your doctor if you have any questions.

Several studies have shown that there is relation between HPV and prostate cancer. As the HPV vaccine is relatively new, the preventative role of HPV vaccines in prostate cancer requires more data to validate its use and further investigation. However, the HPV vaccine has been shown to have warts and other types of cancers in men.

What we can do for you:

Click here to make an appointment.

iDOC Clinic services:

• PSA tests
• DRE examination
• HPV vaccinations
• Referrals for Prostatic biopsy
• Follow up for BPH