What is prostate cancer?

The prostate is a male sex gland which produces a thick fluid that forms part of the semen. Prostate cancer results from an abnormal growth of the cells in the prostate.

What causes it?

The causes for prostate cancer are not yet fully understood. However, we know that some factors are associated with an increased risk of developing prostate cancer.

The major risk factors of prostate cancer include:

• Age: prostate cancer happens mostly in older men and is rarely found in men below the age of 50
• A family history of prostate cancer

Results from studies on other risk factors are inconclusive.

How can I prevent it?

Certainly adopting a healthy lifestyle minimizes the risk of getting prostate cancer. This means you have to eat lots of fruits, vegetables, grains and cereals, but not much meat and animal fat.

If you have a family history of prostate cancer, consult your doctor on this for the necessity of screening.

What should I do if I have suspicious symptoms?

If you notice any symptoms as described above, you should consult a doctor immediately.

For suspected cases, the doctor may carry out some investigations. These include digital rectal examination (DRE), prostate-specific antigen test (PSA), blood tests, urine tests, ultra sound examination and procedures to obtain tissue samples for laboratory examination.

Screening for prostate cancer?

There are two tests used for prostate cancer screening, and they are digital rectal examination and prostate-specific antigen test.

The digital rectal examination (DRE) is performed by a doctor who will put a gloved finger into your back passage to feel the back portion of the prostate to determine whether the prostate is abnormal.

The prostate-specific antigen test (PSA) involves drawing a blood sample from you to measure the level of PSA in your blood. PSA is produced by prostate glands and released into the blood. Several abnormal conditions of the prostate like benign prostatic hypertrophy (BPH), prostatitis (inflammation of the prostate) or prostate cancer could cause an increase in the blood PSA level.

However, unless you experience symptoms, before you decide to go for a DRE / PSA blood test, consider the following facts:

1. The accuracy of the DRE is dependent on the skill and experience of the person who performs the test,

• about 5 out of 6 men with abnormal DRE results do not have prostate cancer, and on the other hand

• about 1 out of 2 men with prostate cancer may not be detected by DRE

2. Since an increase in PSA level could be caused by conditions other than prostate cancer,

• about 3 out of 4 men with a raised PSA level do not have prostate cancer, and on the other hand

• about 1 out of 4 men with prostate cancer may not have a raised PSA level

What further test will be done to confirm a diagnosis of prostate cancer?

If the results of DRE and/or PSA test, which are not definitive diagnostic test, are abnormal, your doctor may refer you to a specialist for further investigations. Such investigations include a prostate ultrasound and removal of tissue samples (biopsy) from the prostate to determine whether cancer is present.

Treatment for prostate cancer depends on the size of the tumour, whether the cancer has spread and the presence of any other medical conditions. It may include the following:

• Watchful waiting - involves monitoring the patient by performing the PSA test and DRE regularly, and treating it only when the prostate cancer shows signs of growing
• Surgery - involves an operation aiming to cure the cancer by removing the prostate gland
• Hormone therapy - aims to reduce the size of the prostate and keep prostate cancer cells from growing
• Radiotherapy - involves a course of radiation treatment and may prevent the spread of cancer

However, apart from watchful waiting, the treatment of prostate cancer may have side effects.