Prostate Cancer

The prostate is part of a man’s reproductive system. It is located in front of the rectum and under the bladder. It surrounds the urethra, the tube through which urine flows. A healthy prostate is about the size of a walnut. It produces a fluid that forms part of the semen.

Prostate cancer occurs when cells in the prostate grow and multiply uncontrollably. The nodular tumour mass invades the surrounding tissues and eventually spread to the lymph nodes, skeletal bones and other regions of the body. Prostate cancer is the fifth most common cancer in Singaporean males and the most common cancer in American men.


Early prostate cancer often has no symptoms. If symptoms are present, they vary from man to man, and may include:

  • frequent, difficult or painful urination
  • not being able to urinate
  • weak or interrupted urine flow
  • blood in the urine
  • blood in the semen
  • painful ejaculation
  • frequent pain or stiffness in the lower back, hips or upper thighs

Many of these symptoms are not cancer, but if you notice one or more of them for more than two weeks, see your doctor.

Risk Factors

Many factors may influence the development of prostate cancer, including:

  • Age: Men 50 or older are at the greatest risk. Age is the most influential risk factor.
  • Family history: Your risk is higher with a family history of prostate cancer (especially father, brother, son)
  • Diet: A high-fat diet, particularly animal fats, may increase your risk. Diets high in fruits and vegetables are thought to decrease your risk.

You can take action to reduce your risk of developing prostate cancer.:

  • reduce diet rich in animal fat
  • increase diet rich in lycopene (tomatoes), selenium (seafood), vitamin E, isoflavonoids (soy products)
  • eating at least five servings of fruits and vegetables per day
  • exercising regularly
  • maintaining your ideal weight

Early Detection

Your best chance for surviving prostate cancer is detecting it early. When prostate cancer is found early and treated appropriately, there is nearly a 100% chance for cure.

Prostate cancer screening should begin at age 50. Men with positive family history (father, uncle or brother has prostate cancer) may begin screening at age 45. Doctors use 2 tests to screen for prostate cancer – PSA blood test and DRE.

Digital Rectal Exam (DRE): The physician inserts a lubricated, gloved finger into the rectum to assess the size, shape, symmetry and consistency of the prostate. If the prostate gland is irregularly enlarged and hard, it is likely to be cancerous.

Prostate Specific Antigen (PSA) Test: This simple blood test measures the level of PSA – a protein produced by the prostate. Normal PSA values vary with age and race. Generally, the higher the level of PSA, the greater the risk for prostate cancer. Benign prostate enlargement, urinary tract infection and prostatitis may also cause a rise in PSA. A small percentage of prostate cancer can have normal level PSA. As such, while this PSA test is not perfect, it is the best available at this point in time.

Normal PSA: Age 40 -49 ( less than 2.5 ug/L), 50 – 59 ( less than 3 ug/L), 60-69 ( less than 4 ug/L)

To schedule a prostate cancer screening test, call (+30)-210-6867819.

What’s next after screening ?

If the digital rectal exam or the PSA test is abnormal, a prostate biopsy is necessary. Only a biopsy can confirm the presence of prostate cancer. This is a clinic procedure whereby under ultrasound guidance, the doctor uses special needles to remove small strips of prostate tissue from different areas of the prostate. The prostate tissue samples are viewed under a microscope to see if cancer calls are present.

What if the biopsy is positive ?

If your biopsy results are positive for prostate cancer, more tests including CT scan, MRI scan and bone scan may be required. These tests help to describe the stage or extent of the cancer.


Treatment options are discussed and they are based on age of patient, PSA level, biopsy result, and stage of disease. Treatment options include surgery, radiation, hormonal therapy, chemotherapy or “watchful waiting” (not treating the cancer and monitoring it closely).