Prostate Cancer is the 4th most common cancer among Malaysian men. Very few prostate cancers occur in men under 50 years of age. The rate increases sharply with age and is highest in the oldest age group.
Leading the Way in Prostate Health
Subang Jaya Medical Centre has written this booklet to help patients with prostate cancer and their families and friends better understand this disease. We hope others will read it as well to learn more about prostate cancer.
As a comprehensive cancer centre – SJMC Cancer and Radiosurgery Centre is recognised for its expertise and leadership in advanced cancer treatment and as a one-stop cancer centre designed to provide patient-focused care in a comfortable and safe environment.
It is our hope that this brochure will provide you with relevant information and coping techniques as well as answer some of the questions you may have. This brochure only serves as a guide and its contents are not to be taken as medical advice. You will still need to discuss with your doctor the best treatment option for you.
About Prostate Cancer
The prostate is part of a man’s reproductive system. It’s an organ located in front of the rectum and behind the bladder. The prostate surrounds the urethra, the tube through which urine ﬂows. The prostate is a gland that secretes the seminal ﬂuid. During ejaculation, the seminal ﬂuid helps carry sperm out of the man’s body as part of semen. A healthy prostate is about the size of a walnut. If the prostate grows too large, it squeezes the urethra. This may slow or stop the ﬂow of urine from the bladder to the penis.
Cancer is found in the prostate only, usually during another medical procedure. It cannot be felt during the Digital Rectal Examination or seen on imaging tests.
This stage describes a tumor that is too small to be felt or seen on imaging tests. Or, it describes a slightly larger tumor that can be felt during a Digital Rectal Examination. The cancer has not spread outside of the prostate gland.
The cancer has spread beyond the outer layer of the prostate into nearby tissues. It may also have spread to the seminal vesicles.
This stage describes any tumor that has spread to other parts of the body, such as the bladder, rectum, bone, liver, lungs, or lymph nodes.
Doctors and staff members at the Centre are committed to enhancing each patient’s well-being, both physically and emotionally. Their goals are to ensure that patients receive the highest quality care, whether seeking prevention and screening services, receiving treatment or coping with a cancer diagnosis. Support groups and other services provide emotional and psychological beneﬁts that can ease many aspects of their daily life.
There is no known exact cause of prostate cancer. Doctors often cannot explain why one man develops prostate cancer and another does not. However, research has shown that men with certain risk factors are more likely than others to develop prostate cancer.
Age Over 65
Age is the main risk factor for prostate cancer. The chance of getting prostate cancer increases as you get older. This disease is rare in men under 45.
Your risk is higher if your father, brother, or son had prostate cancer.
Prostate cancer is more common among male Caucasians compared to Asian men.
Some studies suggest that men who eat a diet high in animal fat or meat may be at an increased risk of prostate cancer. Men who eat a diet rich in fruits and vegetables may have a lower risk.
Talk to your doctor if you think you may be at risk. Your doctor may be able to suggest ways to reduce your risk and can plan a schedule for regular checkups.
Signs and Symptoms
Many men with prostate cancer experience no symptoms; the ﬁrst indicator that they may have the disease is often an abnormal ﬁnding in their routine screening test. Others may notice one or more of the following symptoms:
- Blood in urine
- Frequent urination (or an inability to urinate)
- Trouble starting or holding back urine ﬂow
- Pain in the lower back or hips
- Painful ejaculation or inability to have an erection
Some of these symptoms could also be a sign of a common, non-cancerous condition called Benign Prostatic Hyperplasia (BPH), an enlargement of the prostate gland. It is important to seek medical attention for any of these symptoms to ensure proper diagnosis and treatment.
Screening and Testing
Prostate cancer can be diagnosed through the following clinical ﬁndings and laboratory tests.
Digital rectal examination
Your doctor will examine the prostate through the rectum to determine if there are any abnormalities.
Prostate Speciﬁc Antigen (PSA) level
PSA is a substance produced by the prostate to liquefy semen. A higher than normal level may indicate cancer.
Transrectal ultrasound-guided biopsy
Tissue samples taken from the prostate through the rectum under guidance of ultrasound are tested for the presence of cancer cells.
Once prostate cancer has been diagnosed, your doctor may perform scans of the pelvis and bone to determine if the cancer has spread.
Early Detection Means High Cure Rate
Patients with early stage prostate cancer has very high cure rate. Please visit our health screening centre for more information on screening packages.
Making a Decision About Treatment
- It is very important to have a skillful multidisciplinary team to treat prostate cancer as there are numerous treatment options
- SJMC brings together the most advanced resources to manage the treatment of patients with early or advanced prostate cancer
- Our multidisciplinary team includes urologists, clinical oncologists and radiologists working together to create the most effective treatment plan
- Our doctors make sure that each patient thoroughly understands factors such as the stage and grade of his tumour and the range of treatment options, as well as the potential side effects of each therapy
- Doctors here can guide patients through the sometimes complicated choices posed by these factors
Helical TomoTherapy and Volumetric Arc Therapy (VMAT)
- In the past, there was diﬃculty for radiation beams to target the tumour precisely, which meant healthy tissues were also damaged during cancer treatment; today, new systems used at SJMC takes radiation therapy into the 21st century
- The helical TomoTherapy system couples three dimensional imaging with innovative intensity – modulated radiation therapy, or IMRT, to target mainly the tumour, while sparing the healthy tissues around it
- Volumetric Arc Therapy (VMAT) is an advanced form of radiation treatment using Varian TrueBeam STX also called RapidArc radiotherapy technology to deliver fast and accurate treatment
The SJMC Cancer & Radiosurgery Centre is equipped with sophisticated and highly advanced Tomotherapy HiArt system & Varian TrueBeam System.
All our patients have access to the Cancer & Radiosurgery Centre Patient and Family Resource Centre, which offers a wide array of support and educational services including:
- Oncology Nurse Educator
- Patient & Family Liaison Oﬃcer
- Pain Management Specialiststs
- Cancer Careline
Programmes which patients can participate in include:
- Diet workshops
- Support group/activities
- Yoga & exercise workshops
Understanding Patient’s Needs
The support of the healthcare team can help patients feel less alone and improve the quality of care delivery.
Lutetium-177 PSMA Therapy, or Prostate-Specific Membrane Antigen Therapy, is treatment that is increasingly being used for people with advanced prostate cancer. This therapy aims to reduce the size of the tumour/s and stop them from multiplying, as well as to ease the symptoms that people may get with these tumours. It is most often used when the disease has metastasised and when other therapies are poorly tolerated or have failed.
Prostate cancer is a common type of cancer in men. Staging of prostate cancer to detect the state of the disease can be carried out with various methods such as CT, MRI and bone scintigraphy. However, the Galium-68 PSMA PET CT method can be used to image the entire body and detect the spread of diseased tissue with high sensitivity. Until recently, it has not been possible to observe early metastatic spread to lymph nodes and bone. Galium-68 PSMA PET/CT scan is a new diagnostic technology that assists in locating and determining the extent of prostate cancer. With PSMA scans, therapy can be targeted more directly as it can assess the area of the prostate, as well as lymph nodes and bones.