Prostate Cancer Treatment: What Are Your Options?

Perhaps it started with a routine health check, a raised PSA result, or a lingering concern you could not quite explain. Hearing the words “you have prostate cancer” can be unsettling, leaving you with more questions than answers about what comes next. While the diagnosis may feel overwhelming, understanding your treatment options is a powerful first step towards regaining a sense of clarity and confidence.

Today, prostate cancer care offers a wide range of effective treatments, carefully tailored to your needs and what matters most to you. In this article, we look at the available prostate cancer treatment options and what each involves. Keep reading to learn more.

Understanding Prostate Cancer

Prostate cancer is one of the most commonly diagnosed cancers among men in Singapore and worldwide. It develops in the prostate, a small gland located below the bladder that plays a role in producing seminal fluid. That said, not all prostate cancers behave in the same way. Some grow so slowly that they may never cause symptoms or require intervention, while others are more aggressive and need prompt treatment.

Diagnosis usually involves a combination of assessments, including a digital rectal examination, blood tests such as the prostate-specific antigen (PSA) test, and imaging. If cancer is suspected, a prostate biopsy may be performed to confirm the diagnosis and determine the Gleason score, which helps indicate how aggressive the cancer cells are. Treatment decisions are guided by the cancer’s stage and grade, alongside your general health and life expectancy.

Prostate Cancer Treatment Options

Prostate cancer treatment is highly individualised. Your specialist will consider the characteristics of the tumour, your overall wellbeing and your personal preferences when recommending a treatment plan. Common options include the following:

Active Surveillance

For men with low-risk prostate cancer that is small, low-grade and confined to the gland, active surveillance is often recommended. This approach involves regular monitoring through PSA blood tests, digital rectal examinations and occasional repeat biopsies.

The goal is to delay or avoid invasive treatment and its potential side effects, such as incontinence or erectile dysfunction, unless there are signs that the cancer is progressing. However, active surveillance is suitable only when the likelihood of the disease causing harm during your lifetime is low.

Surgery

Surgical removal of the prostate gland, known as a prostate cancer prostatectomy, is a curative treatment option typically reserved for localised cancer. Advances in surgical technology mean that many prostatectomies are now performed using minimally invasive techniques. Robotic-assisted laparoscopic radical prostatectomy (RALP) is widely used and offers benefits such as smaller incisions, less blood loss, reduced post-operative pain, shorter hospital stays and quicker recovery compared to traditional open surgery.

Radiotherapy

Radiotherapy uses high-energy radiation to destroy cancer cells and can be used either as a primary treatment for localised prostate cancer or to relieve symptoms in more advanced disease.

There are two main methods of delivery:

• External Beam Radiotherapy (EBRT): Beams are directed at the prostate from a machine outside the body. Modern techniques like intensity-modulated radiotherapy (IMRT) allow for highly precise targeting, sparing surrounding healthy tissue.
• Brachytherapy: Radioactive seeds or temporary wires are placed directly into the prostate, allowing a high dose of radiation to be delivered locally while limiting exposure to nearby organs.

Hormonal Therapy

Also known as androgen deprivation therapy (ADT), hormone therapy for prostate cancer works because prostate cancer cells are typically fuelled by male hormones (androgens), primarily testosterone.

This treatment is not curative on its own but aims to stop the body from producing or utilising these hormones, thereby shrinking the cancer or slowing its growth. It is commonly used for patients with advanced stages of prostate cancer, often in conjunction with radiotherapy, or to manage metastatic prostate cancer that has spread to other parts of the body.

Chemotherapy

Chemotherapy involves the use of anti-cancer drugs administered intravenously to target rapidly dividing cells. It is not usually part of initial treatment for early-stage prostate cancer but plays an important role when the disease becomes advanced or resistant to hormonal therapy, a stage known as castration-resistant prostate cancer.

In these cases, chemotherapy can help control symptoms, slow progression and improve quality of life.

Take the Next Step with Professional Guidance

A prostate cancer diagnosis does not mean there is only one path forward. With professional guidance and a personalised treatment plan, many men achieve excellent outcomes while maintaining a good quality of life.

If you would like a thorough assessment or to discuss your treatment options in confidence, reach out and schedule an appointment with our prostate cancer specialists today. Early consultation can help you make informed decisions and move forward with clarity and reassurance.