Prostate cancer is one of the common cancers among men in Singapore. Treatment decisions depend on many factors such as stage, patient’s age, health, tumour grade, and patient preferences. This article explains how Singapore treats prostate cancer, the therapies available, and what people should expect during care.
Diagnosis and Initial Assessment
Treatment begins with diagnosis and staging. Doctors use several tests to decide how advanced the cancer is. This assessment guides what treatment paths are possible.
Screening and Biomarkers
Singapore uses prostate-specific antigen (PSA) blood tests to check for elevated levels. PSA alone doesn’t confirm cancer High , but it triggers further checks. Digital rectal examinations (DRE) also occur to detect lumps or irregularity.
Doctors also assess the Gleason score from biopsy. The Gleason score rates how aggressive the cancer cells look under a microscope. Higher scores mean a more aggressive tumour.
Imaging and Biopsy
Imaging tests include MRI, CT scans, and bone scans. These help determine whether cancer has spread. A prostate biopsy confirms diagnosis and helps in staging.
Treatment Options for Localised Prostate Cancer
Localised prostate cancer means the cancer is contained within or just around the prostate. In these cases, curative treatment is often possible. Singapore offers several options depending on risk level.
Active Surveillance
Doctors may suggest active surveillance for men whose cancer is low risk, slow-growing, and not causing symptoms. With this option, clinicians monitor PSA levels, imaging results, and perform periodic biopsies. Treatment only starts if signs of progression appear.
Surgery
Radical prostatectomy means removing the prostate gland. Surgeons in Singapore perform both open and minimally invasive surgery (laparoscopic or robotic-assisted). Minimally invasive methods often reduce recovery time and reduce certain risks.
Radiation Therapy
Radiation therapy uses high-energy beams to kill cancer cells. Singapore provides external beam radiation as well as brachytherapy (implanting radioactive sources in or near the prostate). Newer modalities like SBRT (Stereotactic Body Radiotherapy) allow shorter treatment courses. Proton therapy is also available in selected centres.
Treatment for Advanced or Metastatic Prostate Cancer
When cancer spreads beyond the prostate or shows high-risk features, treatment aims to control disease, relieve symptoms, and improve survival.
Hormone Therapy
Also known as androgen deprivation therapy (ADT), this treatment reduces male hormones (androgens) that fuel many prostate cancers. Singapore uses this in advanced cases, or in combination with radiation for locally advanced cancers.
Chemotherapy and Targeted Agents
If hormone therapy no longer works or cancer spreads, chemotherapy or newer anti-androgen drugs may be used. These aim to kill or slow cancer growth. Treatments may include novel agents that block androgen effects or target certain molecular pathways in cancer cells.
Radiation for Metastatic Sites
Radiation may also treat metastases. For example, SBRT can target detectable spread to bones or lymph nodes. This helps with symptoms and may delay other systemic treatments.
Advances and Innovations in Singapore’s Treatment Landscape
Singapore constantly updates its approaches. Innovations aim to enhance precision, reduce side effects, and improve patient outcomes and quality of life.
Short-Course Radiotherapy (SBRT)
SBRT delivers high doses of radiation with precision in fewer sessions. It can replace longer standard radiotherapy in suitable early or localized cancers. Patients complete treatment in a shorter time with comparable control and often fewer side effects.
Proton Therapy
Proton therapy represents advanced radiation technique. It targets tumours while sparing nearby tissues more than some X-ray based methods. Proton therapy is especially helpful where the prostate is close to sensitive organs.
Protection of Surrounding Organs
Technologies like hydrogel spacers (e.g. SpaceOAR) help protect rectum during radiation treatment. These tools reduce risk of damage to healthy tissue, mitigating side effects such as rectal irritation.
Side Effects, Risks, and Quality of Life Considerations
Treatment decisions also consider potential side effects and how they may affect daily life. Balancing benefits and risks matters.
Urinary, Sexual, and Bowel Function
Surgery and radiation can affect urinary control, sexual function (erectile function), and bowel habits. Minimally invasive surgery and precise radiation aim to minimize these effects.
Recovery Time and Hospitalisation
Open surgery often involves longer hospital stays and recovery. Minimally invasive or image-guided methods tend to reduce recovery time. Active surveillance avoids surgery or radiation unless needed, so recovery is minimal.
Monitoring and Follow-Up
Even after treatment, patients need regular follow-ups with PSA tests, imaging, possibly biopsies. Monitoring helps detect recurrence early. Some treatments also require long term hormone therapy.
How Treatment Choice is Made
Choosing the right treatment path is a personalized process. Doctors discuss options with patients considering many factors.
Risk Stratification
Doctors assess risk using PSA level, Gleason score, imaging, and whether the cancer seems confined or has spread. These determine whether treatment aims for cure or disease control.
Patient Age, General Health, Life Expectancy
Older patients or those with other health issues may prefer less aggressive approaches. Younger and healthier patients with longer expected lifespan may opt for treatments aiming at cure.
Patient Preferences and Values
Patients consider side effects, treatment time, recovery, impact on quality of life. Some may accept risk of certain side effects to achieve best survival. Others may prefer to avoid side effects even if that means accepting modest risk. Doctors help weigh these trade-offs. For more information
Costs and Access in Singapore
Treatment costs in Singapore vary based on public vs private institutions, treatment type, and subsidies. Government schemes help reduce financial burden for eligible citizens.
- Public healthcare institutions often subsidize treatments including surgery, radiation, hormone therapy.
- Proton therapy and newer modalities may cost more than conventional therapies. Access depends on availability and institutional infrastructure.
- Medication assistance funds and insurance plans may help with high-cost drugs, especially in advanced cancer treatment.
Summary and Outlook
Prostate cancer treatment in Singapore offers a broad spectrum of options. From surveillance for low-risk disease to surgery, radiation, hormone therapy, chemotherapy, and advanced techniques like proton therapy. Innovations aim to improve outcomes and reduce adverse effects.
Treatment choice depends heavily on disease stage, patient health, and personal values. Through careful assessment and shared decision making, patients can find paths that balance survival, quality of life, and treatment burden.
