Treat prostate cancer early

After being diagnosed with prostate cancer in January, Prime Minister Lee Hsien Loong went through an operation to remove his prostate gland yesterday.

The robot-assisted keyhole surgery was successful, says a statement from the Prime Minister's Office.

However, oncologist Wong Seng Weng has warned that prostate cancer, if left untreated, can still be fatal, much like other forms of cancer.

The medical director of The Cancer Centre, a Singapore Medical Group clinic, said: "My fear is that people may get the idea that they won't die from prostate cancer."

Prostate cancer is the fifth leading cause of death and the third most common disease among men, latest statistics from the National Cancer Centre Singapore show.

Every year, there are about 700 new cases but this does not include those that go undetected, Dr Wong said.

Unlike in the US, there is no habit of testing for the prostate specific antigen (PSA) here regularly. High levels of PSA may suggest prostate cancer.

Khoo Teck Puat Hospital's Dr Colin Teo said the undetected cases could be due to men's "self-seeking behaviour".

"While prostate cancer is generally a slow-growing cancer and not a major killer so to speak, there is still that fear of cancer and a lot of men would rather not know.

"So they tend not to consult a doctor even if they are aware (of the symptoms)," said the head of the urology department.

There are two kinds of prostate cancer - one spreads quickly while the other is slow-growing.

There is a Gleason score, ranging from two points to 10 points, that evaluates the type of prostate cancer, said Dr Wong.

SPREADING

The higher the score, the faster the tumour spreads - first to the bones, then lungs and liver, he said.

In the case of an elderly man who has slow-growing prostate cancer, he may be advised against seeking treatment, Dr Wong added.

"If the elderly person has multiple other medical problems that are probably going to affect his longevity, what is the motivation for treating?" he said.

Age and race have been named as risk factors for prostate cancer, but those who have undergone chemotherapy previously could also be at risk, Dr Wong said.

"Chemotherapy sometimes causes damage to other cells. Those that do not repair themselves completely lose control and become cancer cells.

"If the second cancer is truly related to chemotherapy exposure previously, it could take more than 10 years to advance," he said.

Some side effects experienced by patients following the surgery include "leaking", said Dr Lewis Liew.

"The joint of the bladder to the urethra can sometimes give rise to problems. With robotic surgery, most patients have leaks only in extreme situations, like when they cough and sneeze," said the urologist in private practice.

In more aggressive surgeries, Dr Teo said patients may experience erectile dysfunction.

"The erectile nerves hug the capsule of the prostate. In order to take the cancer out, you will have to touch the nerves," he explained.

He added that it is a matter of days before the patient recovers from surgery.

"It is not the end of the world to be diagnosed with prostate cancer. As long as it is detected early, the recovery and function after surgery is very good," he said.