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258499, Singapore

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Prostate Cancer

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What Is Prostate Cancer?

Prostate cancer is a disease that develops when abnormal cells in the prostate—a small walnut-shaped gland that produces seminal fluid to nourish and transport sperm—begin to grow and divide uncontrollably, leading to the formation of a tumour. While most cases of prostate cancer progress slowly and remain confined to the prostate, they may spread through the lymphatic system to other parts of the body, such as the bones and lungs (metastasis).

Prostate cancer is the third most common type of cancer among men in Singapore and typically occurs in those over 50 years old.

What Are the Types of Prostate Cancer?

Prostate cancer can be classified based on the specific cell type from which the abnormal cells originated and its level of aggressiveness. Here are the different types of prostate cancer:

  • Adenocarcinoma – The most common form of prostate cancer, making up around 95% of all cases. It originates in the glandular cells of the prostate and usually progresses slowly with a low risk of spreading.
  • Small Cell Carcinoma – A rare but aggressive type that develops from small, round neuroendocrine cells, which regulate hormone release in response to nervous system signals. It does not produce prostate-specific antigen (PSA), making early detection challenging.
  • Transitional Cell Carcinoma – Also known as urothelial carcinoma, transitional cell carcinoma is another rare type of prostate cancer that arises in the cells lining the urethra, sometimes developing near the bladder entrance and spreading to the prostate.
  • Sarcomas and Neuroendocrine Tumours – Sarcomas originate in connective tissues such as muscle, fat, fibrous tissue, and blood vessels. Neuroendocrine tumours arise from hormone-producing cells within the prostate and are distinct from small cell carcinoma.

Do I Have Prostate Cancer?

As prostate cancer is a prevalent condition that affects many individuals, it is essential to be well-informed about the risk factors and symptoms associated with prostate cancer to promote early detection and timely intervention.

What Are the Risk Factors for Prostate Cancer?

While the precise reason for prostate cells becoming cancerous is not fully understood, several factors may increase the risk of prostate cancer. These include:

  • Family History

    - Individuals with a first-degree relative (brother or father) are at higher risk than others, with an even greater risk if more than one relative is affected.

  • Age

    - The risk of prostate cancer increases with age, especially after the age of 50, and most commonly among those aged 60-70.

  • Genetics

    - Prostate cancer tends to be more common in Africans and rarer in Asians.

  • Diet

    - Studies suggest a link between having a diet high in saturated fat, well-done meats, and calcium and an increased risk of prostate cancer.

What Are the Symptoms of Prostate Cancer?

Prostate cancer often develops without noticeable symptoms in its early stages. Since many cases progress slowly, men may remain unaware of their condition until it is incidentally detected during routine screenings. However, when symptoms do appear, it is crucial to recognise them and seek medical attention from a urologist immediately. Consult your healthcare provider if you experience the following symptoms for an accurate diagnosis and treatment plan:

  • A frequent need to urinate at night
  • Difficulty urinating
  • Pain or burning when urinating
  • Weak urine stream
  • Blood in the semen or urine
  • Stiffness or pain in the thighs, lower back and hips
  • Painful ejaculation
  • Erectile dysfunction

What Are the Stages of Prostate Cancer?

The stage of prostate cancer is determined through a TNM system, which is based on the size and extent of the primary tumour (T), whether cancer has spread to nearby lymph nodes (N), and if cancer has metastasised to distant parts of the body (M).

The main stages of prostate cancer are as follows:

  • Stage I – The cancer is small and confined to the prostate, which cannot be detected with physical exams or imaging techniques. The tumour usually occupies less than half of one prostate lobe.
  • Stage II – The tumour has grown and potentially will be more aggressive, but remains localised within the prostate gland.
  • Stage III – The cancer has progressed beyond the outer layer of the prostate gland and infiltrated nearby tissues, such as the seminal vesicles.
  • Stage IV – The disease has spread to nearby lymph nodes, bones or organs, including the bladder, rectum, and lung.
As the early stages of prostate cancer are often asymptomatic, regular screenings are crucial to improve your chances of successful treatment, especially once you reach your 50s.

How is Prostate Cancer Diagnosed?

Prostate cancer is usually identified through a series of tests, following a detailed physical examination and review of the patient’s medical history. This comprehensive approach allows the specialist to determine the cancer's stage (extent of spread), including whether it has invaded surrounding organs, and how quickly it is likely to grow (grade).

Some tests for prostate cancer diagnosis include:

A digital rectal examination is a quick and simple test where your urologist inserts a lubricated gloved finger into the rectum and gently feels for abnormal growths. The DRE is often conducted as part of a routine physical examination. Although it may cause some discomfort, it should not be painful.

Having published the first local study on the PHI in Singapore, Dr Lincoln Tan is especially knowledgeable on the PHI test and its efficacy in safely checking for prostate cancer.

What is a Prostate Biopsy?

A prostate biopsy is a procedure to remove and analyse tissue samples from the prostate gland, providing a definitive confirmation of the presence or absence of prostate cancer. This can be accomplished by inserting a needle either through the rectal wall (transrectal) or through the skin between the anus and scrotum (transperineal). Due to the potential for serious infections from transrectal prostate biopsies, it is advisable to undergo transperineal prostate biopsies when necessary.

Transperineal prostate biopsy is a newer method of obtaining tissue samples by passing a needle through the area of skin between the anus and scrotum (perineum). This method is considered to be an improvement over transrectal biopsy, particularly because of the following:

  • Safer & Sterile - Minimal risk of infection as the needle avoids contact with faecal content
  • Better Access - Easier sampling from hard-to-reach areas of the prostate
  • No Antibiotics - This avoids the possibility of bacteria building up antibiotic resistance
  • More Comfortable - No needle punctures of the sensitive rectum, avoiding rectal bleeding
  • Smoother Process - Hospitalisation and general anaesthesia are not required
  • More Precise - Real-time ultrasound and MRI scans accurately guide your urologist
While urinary symptoms of BPH tend to be more common with age, they should not be accepted as a normal part of life.

Consult a urologist for relief of these discomforts.

What Are My Treatment Options for Prostate Cancer?

The treatment for prostate cancer is typically tailored based on the stage of the disease (whether localised or advanced) at the point of diagnosis, as well as the patient’s age and general health.

In some cases, the prostate cancer treatment plan involves one or more of these approaches:

If the cancer has been detected early and is not growing quickly or spreading, your urologist may recommend close monitoring. This involves regular PSA measurements and, if necessary, repeat MRIs and prostate biopsies to monitor the cancer’s progression. This prevents overtreatment of slow-growing cancers and exposure of patients to unnecessary treatment-related side effects, without compromising cancer cure should tests show that the cancer has progressed and needs more aggressive treatment.

As an accredited robotic surgeon with a particular interest in laparoscopic and robotic-assisted surgery, Dr Lincoln is well-equipped to provide his patients with comfort and positive outcomes in prostate cancer treatment.

Radiation therapy, or radiotherapy, is a common recommendation for men with high-risk prostate cancer. Its purpose is to destroy cancer cells while minimising any negative impact on the surrounding areas. It can also be used to ease symptoms of the cancer spread, such as bone pain relief, by being directed at areas of cancer outside the prostate.

There are two primary types of radiotherapy for prostate cancer: external beam radiotherapy, which is administered from outside the body, and brachytherapy, which involves inserting radioactive seeds or needles into the prostate.

When determining what one's prostate cancer treatment will entail, it is valuable to seek multiple consultations and second opinions from specialists. These steps will help you thoroughly explore your options and make an informed decision.

Meet Our Prostate Cancer Specialist in Singapore

Prostate Cancer Doctor - Dr Lincoln Tan
Dr Lincoln Tan
Consultant Urologist
MBBS, MRCS(EDIN), MMED(SURG), FRCS(UROL) (RCPSG), FAMS(UROL)

Dr Lincoln Tan is a consultant urologist and accredited robotic surgeon in Singapore dedicated to providing comprehensive care for men with prostate cancer. He has a special interest in advanced laparoscopic and robotic-assisted surgery.

Dr Tan obtained a fellowship in Urologic Oncology and Tele-Robotic Surgery at the Royal Melbourne Hospital and is a passionate advocate for men’s health and prostate cancer patients. He remains actively involved in Movember fundraising campaigns and prostate cancer survivorship initiatives. Adopting a patient-centred approach, Dr Tan prioritises listening to his patients’ concerns and delivering personalised care to achieve optimal outcomes.

Your Prostate Health is Our Priority

Location

6 Napier Road #05-03,
Gleneagles Medical Centre,
258499, Singapore

Contact Us

Phone    : +65 6732 6503
Email    : info@tanurology.com.sg