What Is Prostate Cancer?

Prostate cancer is a disease which develops when the cells in the prostate gland begin to grow and divide uncontrollably, leading to the formation of a tumour. While most cases of prostate cancer progress slowly and remain confined to the prostate, they may spread to other parts of the body. Prostate cancer is the third most common type of cancer in Singaporean men and usually occurs in men over 50 years old.

Do I Have Prostate Cancer?

As prostate cancer is a prevalent condition that affects many individuals, it is essential to be well-informed about the risk factors and symptoms associated with prostate cancer to promote early detection and timely intervention.

Risk Factors for Prostate Cancer

While the precise reason for prostate cells turning cancerous is not understood, several factors may put you at a higher risk of prostate cancer. (1) Family history - Individuals with a first-degree relative (brother or father) are at higher risk than others, with an even greater risk if more than one relative is affected. (2) Age - The risk of prostate cancer increases with age, especially after the age of 50, and most commonly so for those aged 60-70. (3) Genetics - Prostate cancer tends to be more common in Africans and rarer in Asians. (4) Diet - Studies suggest a link between having a diet high in saturated fat, well-done meats, and calcium and an increased risk of prostate cancer.

Symptoms for Prostate Cancer

You should seek medical attention from a urologist if you experience any of the following early warning signs of prostate cancer: A frequent need to urinate at night, Difficulty urinating, Blood in the semen or urine, Stiffness or pain in the thighs, lower back and hips, and Erectile dysfunction.

Diagnostics Test For Prostate Cancer

(1) Digital Rectal Exam (DRE) - A digital rectal examination is a quick and simple test where your urologist inserts a lubricated gloved finger into the rectum and gently feels for abnormal growths. The DRE is often conducted as part of a routine physical examination. Although it may cause some discomfort, it should not be painful. (2) Prostate-Specific Antigen (PSA) Blood Test - Prostate cancer development leads to an increased production of prostate-specific antigen (PSA), a substance present in semen and the bloodstream. Testing PSA levels in the blood is a common method to screen for prostate cancer. However, as higher levels of PSA may be caused by non-cancerous conditions, additional tests are required to accurately diagnose prostate cancer. (3) Magnetic Resonance Imaging (MRI) - MRI (Magnetic Resonance Imaging) offers detailed images of the prostate gland to assess the risk of prostate cancer. By utilising powerful magnetic fields, an MRI generates an image of the prostate and its surrounding tissues. Nevertheless, studies have shown that MRI may still fail to detect up to 15% of clinically significant cancers. (4) Prostate Health Index (PHI) - To improve the accuracy of prostate cancer diagnosis, a prostate health index (PHI) test may be utilised. This formula combines three types of blood tests into a single “PHI score” to provide insight on the significance of elevated PSA levels and the likelihood of detecting prostate cancer through a biopsy.

A prostate biopsy is a procedure to remove and analyse tissue samples from the prostate gland, providing a definitive confirmation of the presence or absence of cancer. This can be accomplished by inserting a needle either through the rectal wall (transrectal) or the skin between the anus and scrotum (transperineal). Due to the potential for serious infections from transrectal prostate biopsies, it is advised that where available, transperineal prostate biopsies are done when necessary.

Transperineal Targeted Prostate Biopsy

Transperineal prostate biopsy is a newer method of obtaining tissue samples by passing a needle through the area of skin between the anus and scrotum (perineum). This method is considered to be an improvement over transrectal biopsy, particularly because of the following: Safer & Sterile - Minimal risk of infection as the needle avoids contact with faecal content, Better Access - Easier sampling from hard-to-reach areas of the prostate, No Antibiotics - This avoids the possibility of bacteria building up antibiotic resistance, More Comfortable - No needle punctures of the sensitive rectum, avoiding rectal bleeding, Smoother Process - Hospitalisation and general anaesthesia are not required, and More Precise - Real-time ultrasound and MRI scans accurately guide your urologist.

What Are My Treatment Options?

(1) Active Surveillance - If the cancer has been detected early and is not growing quickly or spreading, your urologist may recommend close monitoring. This involves regular PSA measurements and, if necessary, repeat MRIs and prostate biopsies to monitor the cancer’s progression. This prevents overtreatment of slow growing cancers and exposure of patients to unnecessary treatment related side effects, without compromising cancer cure should tests show that the cancer has progressed and needs more aggressive treatment. (2) Robot-Assisted Laparoscopic Radical Prostatectomy - Robot-assisted techniques have emerged as a minimally invasive alternative to open surgery. By utilising robotic assistance, urologists can perform procedures through smaller incisions with enhanced precision. This approach offers several benefits, including reduced pain and complications, shorter hospital stays, and smaller scars. One common source of discomfort during the recovery process is the presence of a urethral catheter to drain the bladder. At Tan Urology, we provide a catheter-less technique for selected individuals. In this approach, the catheter is inserted through a small hole in the lower abdomen instead of the urethra. By avoiding the transurethral catheter, we eliminate any associated discomfort.

前列腺癌 - 诊断与治疗 | 新加坡泌尿科医生

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6号纳皮尔路 #05-03,
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新加坡邮区 258499

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什么是前列腺癌？

前列腺癌指的是由前列腺中的异常细胞生长所形成的恶性肿瘤的疾病。尽管多数前列腺癌发展缓慢并局限于前列腺，却还是有扩散到身体其他部位的可能。

前列腺癌是新加坡第三常见癌症，并主要影响50岁以上的男性。

如何判断是否有前列腺癌？

由于前列腺癌是一种可影响广泛人群的常见疾病，因此了解前列腺癌的风险因素和症状非常重要，以利于及时检测和治疗。

前列腺癌的风险因素有哪些？

尽管导致前列腺细胞发生癌变的确切原因不明，但一些因素有可能会增加患前列腺癌的风险：

有家族病史 - 家族有一级亲属（如父亲、兄弟）曾患前列腺癌的男性患前列腺癌的风险较高。如果不止一名亲属，其风险将提高。
年龄 - 罹患前列腺癌的风险会随着年龄的增长而增加，尤其是年过50 岁的人群，而前列腺癌最常见于60至70岁的人群。
遗传 - 前列腺癌在非洲裔男性中更常见，而在亚洲男性中较为罕见。
饮食 - 研究显示，摄取富含饱和脂肪、熟肉和钙的食物与前列腺癌风险增加存在关联。

前列腺癌的症状有哪些？

在早期阶段，前列腺癌通常没有明显的症状。由于许多前列腺癌发展缓慢并局限于前列腺，大多数男性在老年时并不知道自己患有该病。通常，前列腺癌是在常规体检或通过血液检查时发现的。如果您出现以下任何前列腺癌的早期警示症状，请及时寻求泌尿科医生的帮助：

夜间尿频
排尿困难
精液或尿液中带血
大腿、腰部和臀部僵硬或疼痛
勃起功能障碍

由于早期前列腺癌一般无症状，因此接受定期检查显得更重要。定期检查有利于提高治疗的有效性，尤其是在年过50的人群。

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前列腺癌是如何诊断的？

可用于诊断前列腺的测试有几种，其中包括：

直肠指检是一项简单快速检查。泌尿科医生将戴上涂有润滑剂的手套并用手指插入直肠，以检查是否有异常增生。这项检查被视为常规体检的一部分。过程中，病患有可能会感到轻微不适，但不会引起任何疼痛。

曾发表新加坡本地首份关于前列腺健康指数（PHI）的研究报告，陈元林医生对前列腺健康指数测试及其有效性具有深入了解。

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什么是前列腺活检？

前列腺活检是一项从前列腺取出组织样本的程序，以确定病患是否患有前列腺癌。过程中，将使用一根细针穿入直肠壁（经直肠），或肛门和阴囊之间的皮肤（经会阴）。由于经直肠前列腺活检有可能会造成严重感染，因此，经会阴前列腺活检是更为推荐的检查方式。

经会阴前列腺活检是一项新医疗程序，使用针头将其穿过肛门和阴囊（会阴）之间的皮肤来取出组织样本。这项检查与经直肠前列腺活检相比，更具优势如：

安全及无菌 - 由于针头没有接触到粪便内容物，大大降低了感染机率
良好接触 - 可从不易接触到的前列腺区域获取样本
无需抗生素 - 这避免细菌对抗生素产生抗药性
舒适 - 无需在直肠区域进行穿刺，降低直肠出血的可能
顺畅过程 - 这项检查无需住院或进行全身麻醉
精准度高 - 在实时超声波和核磁共振下进行，提高准确性

陈氏泌尿科是在新加坡和东南亚其中有提供经会阴靶向前列腺活检的医疗诊所之一。

安全有效的前列腺活检方式。

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如何治疗前列腺癌？

治疗前列腺癌的方法诸多，而适当的前列腺癌治疗将取决于癌症分级和程度、病患年龄、整体健康情况，以及病患需求。

对于提早发现的前列腺癌病例，且没有扩散的情况下，泌尿科医生将进行密切观察。这包括进行定期PSA测量、反复MRI影像扫描，和前列腺活检（如需）以观察前列腺癌的进展。这些检测将能防止过度治疗的情况发生，以及避免患者受到不必要治疗的副作用影响。同时，这也能确保需进行的治疗不被忽略，尤其在前列腺癌有恶化并需更积极治疗的情况。

陈元林医生是一名经认证的机器人外科医生，并对腹腔镜手术和机器人辅助手术有特殊兴趣，能为病患提供舒适、有效的前列腺癌治疗。

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放射治疗适用于高危前列腺癌病例，其目的为消灭癌细胞和减少对周围区域的负面影响。这项治疗也适用于前列腺以外的癌症区域，以缓解癌症症状，如减轻骨痛。

放射治疗主要分为体外放射治疗（从体外进行放射治疗）和近距离放射治疗（在前列腺植入放射性针头或颗粒）。

在面临决定治疗方案时，咨询专科医生并获取第二意见十分重要。通过与专科医生的讨论，可确保病患充分了解所有可行治疗选项并做出明智医疗决定。

我们会以
您的前列腺健康为首

地点

6号纳皮尔路 #05-03,
鹰阁医疗中心,
新加坡邮区 258499

联系我们

电话	: +65 6732 6503
电邮	: info@tanurology.com.sg

前列腺癌

什么是前列腺癌？

如何判断是否有前列腺癌？

前列腺癌的风险因素有哪些？

前列腺癌的症状有哪些？

前列腺癌是如何诊断的？

直肠指检（DRE）

前列腺特异性抗原 (PSA) 测试

核磁共振成像（MRI）

前列腺健康指数（PHI）

什么是前列腺活检？

经会阴靶向前列腺活检

如何治疗前列腺癌？

积极观察

机器人辅助腹腔镜根治性前列腺切除术

放射治疗

激素疗法

化疗