Information Resources > Cancers

Q1. What is the prostate and what is its function?

Q2. What is prostate cancer?

Q3. Who is at risk of getting prostate cancer?

Q4. How is prostate cancer diagnosed?

Q5. What are the stages of prostate cancer?

Q6. How is prostate cancer treated?

Q7. What are the side effects of treatment?

Q8. What should I do after my treatment for prostate cancer has been completed?

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Q1.

What is the prostate and what is its function?

A1.

The prostate is a gland of the male reproductive system. It is located in front of the rectum and just below the bladder. Its main function is to produce fluid for semen, which transports sperm.

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Q2.

What is prostate cancer?

A2.

Prostate cancer is a malignant tumour that begins most often in the outer part of the prostate. It may spread to the inner part of the prostate and beyond the prostate, to other parts of the body.

Prostate cancer is the seventh most common cancer in Singaporean men. It is usually curable when detected early, but can kill if diagnosed late or not treated effectively.

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Q3.

Who is at risk of getting prostate cancer?

A3.

Most men who get prostate cancer are 50 years of age or older, and the risk increases with age. top

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Q4.

How is prostate cancer diagnosed?

A4.

In the early stages, when prostate cancer is a small, treatable tumour, there are usually no symptoms.

When the growth becomes more advanced, urinary symptoms may develop. These include:

Frequent urination (especially at night)
Weak urinary stream
Inability to urinate
Interruption of the urinary stream (stopping and starting of the urinary stream)
Pain or burning on urination
Blood in the urine
Bone pain

Rectal examination is the first step in diagnosing prostate cancer. Using a gloved finger to examine inside the rectum, the doctor may be able to feel a hard lump or growth in the prostate. This examination should be part of a regular checkup for all men over the age of 40.

Another test that helps to detect prostate cancer is the presence of elevated levels of prostate-specific antigen (PSA) in the blood. PSA is a substance produced both by normal as well as malignant prostate cells. Some men with BPH or prostatitis (inflamed prostate) have increased levels of PSA even without cancer.

If the initial clinical evaluation suggests the presence of prostate cancer, a biopsy of the prostate is usually recommended. A biopsy of the prostate causes no more discomfort than a visit to the dentist.

If the biopsy is positive, then a bone scan and/or computer scanning may be needed to help determine the extent of the cancer.

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Q5.

What are the stages of prostate cancer?

A5.

The stages of prostate cancer are:

Stage A The tumour cannot be detected by any routine tests but has been found during surgery for another disorder of the prostate or found by biopsy because of elevated levels of PSA.

Stage B The tumour can be felt by rectal examination but it has not spread beyond the prostate gland.

Stage C The cancer has spread beyond the prostate to nearby tissues.

Stage D The cancer has spread to the pelvic lymph nodes or to distant parts of the body, most commonly to the bones.

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Q6.

How is prostate cancer treated? top

A6.

For treating prostate cancer, your doctor may use one or more of the following methods � surgery, hormonal treatment, radiation and anti-cancer drugs. The choice depends upon the stage of the cancer and upon your age and health.

Radical prostatectomy is used to treat cancer localised in the prostate and involves complete removal of the prostate. Often, the pelvic lymph nodes are removed as well.

Radiation therapy uses high-energy x-rays to kill cancer cells. Radiation may be provided from a machine located outside the body (external radiation therapy), or from a radioactive substance introduced directly into the tumour. Sometimes, a combination of these methods is used.

Both surgery and radiation provide excellent 10-year survival rates. Your doctor can help advise you about the best treatment for your cancer.

Hormonal therapy is used to treat prostate cancer that has spread. The 2 basic techniques involve:

Drugs that prevent the release or counter the action of male hormones are administered.
Surgical removal of the testicles, which make the male hormones. Because male hormones stimulate the growth of prostate cancer, treatments that interfere with the effect of these hormones can slow the cancer's growth, sometimes dramatically. Occasionally, chemotherapy is used.

Watchful waiting has also been advocated as a reasonable approach for some men with prostate cancer. Not all men diagnosed with the disease require immediate treatment. Some cancers grow slowly and may take 10 years or more to cause problems or to spread. Immediate treatment may not be necessary for men with an early-stage cancer, whose age and/or general health make it unlikely that they will live for at least 8 to 10 years.

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Q7.

What are the side effects of treatment? top

A7.

Surgical treatment of prostate cancer raises many questions about a man's ability to remain sexually active. For some men, changes including impotence may be temporary, but for others, these problems may be permanent. Urinary incontinence may be present.

During radiation therapy, patients may notice a number of side effects that usually disappear when the treatment ends. For example, patients may have skin reactions (redness, dryness or wetness) in the area being treated, and they may feel unusually tired. Patients may also have diarrhoea, and frequent and uncomfortable urination. In some patients, impotence results after radiation therapy.

Hormonal therapy may also cause side effects. Female hormones (estrogen) may cause breast tenderness and enlargement, nausea, vomiting and water retention. High doses of estrogen also increase the risk of heart problems.

The side effects of chemotherapy depend on the drugs given and the response of the individual patient. Chemotherapy commonly affects hair cells, blood-forming cells, and cells lining the digestive tract. As a result, patients may have side effects such as hair loss, lowered blood counts, nausea or vomiting. Most side effects end after the treatment is over.

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Q8.

What should I do after my treatment for prostate cancer has been completed?

A8.

After treatment for prostate cancer is completed, you should continue to visit your doctor for regular checkups. At various times after your treatment, your doctor will examine you and perform several different tests to determine whether any further treatment is necessary. The PSA test has proved to be particularly useful in monitoring the response of prostate cancer to treatment.

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