In Malaysia, this has been the third-most common cancer among men since 2012. Healthcare professionals urge men aged 50 and above to undergo regular evaluations, as incidence rates rise steeply after 65.
With a population that is growing older, prostate cancer is a serious concern. Yet, nearly three out of four cases are diagnosed at advanced stages, where complications are more severe, treatment options more limited, and survival rates significantly reduced.
“Prostate cancer is insidious, often silent,” Dr Tan Guan Hee, consultant urologist and urologic oncologist, said during a recent media roundtable session at Sunway Medical Centre.
For men, an enlarged prostate can be one of the earliest indicators that something is amiss. However, this and other symptoms such as difficulty urinating are often dismissed as normal signs of ageing.
Sadly, ignoring these symptoms can lead to serious consequences. As such, there’s an urgent need to shift the narrative from reactive to proactive care – starting with breaking the stigma around men’s-health conversations.
“As Asians we tend to be more reserved and private,” Tan continued. “Many of my patients come in experiencing symptoms for around two to three years. They simply refused to see a doctor until it got really bad.”
Early urinary symptoms often include frequent urination, especially at night; difficulty starting or stopping urination; weak or interrupted urinary flow; and the feeling of incomplete bladder emptying.
“The assumption that it’s ‘just ageing’ can delay diagnosis and lead to poorer outcomes,” Tan noted. “General practitioners might even misdiagnose it, as the symptoms mimic other conditions.”
He emphasised that family members, too, need to be aware of the symptoms and risks associated with prostate cancer.
“Once prostate cancer spreads, you can’t cure it, only control it,” he cautioned. And apart from the physical and mental health woes, “in the long-term, that’s a big financial strain”.
In stages 1 and 2, the tumour is still confined to the prostate. Beyond this, the cancer starts to spread to nearby tissues. By stage 4, it has reached other organs.
“The challenge is in ensuring men get to us before the disease becomes aggressive and spreads to the bone,” said consultant clinical oncologist Dr Nik Muhd Aslan Abdullah.
The most widely available screenings include a PSA test, which measures the level of prostate-specific antigen in a man’s blood.
“PSA tests only measure the level of prostate-specific antigen in the blood, but does not reveal to where it has spread,” Nik explained.
Still, targeted therapy could shift outcomes significantly: “With advanced tools like precise imaging and staging, we’re now able to personalise treatment based on a patient’s unique disease profile. This means more effective results, even for those with advanced prostate cancer.”
Advancements in healthcare today involve Prostate-Specific Membrane Antigen (PSMA) imaging and Radioligand Therapy (RLT).
“PSMA is a biomarker found on prostate cancer cells – over 80% of men with advanced disease have high PSMA expression,” explained consultant nuclear medicine physician Dr Tan Teik Hin.
“PSMA imaging can detect tumours as small as 0.3cm and determine how far the cancer has spread. We often say, if we can see it, we can treat it. That’s exactly what this offers.”
This targeted approach helps to spare healthy tissue, and reduces potential systemic side effects. From there, RLT delivers targeted radiation to kill the cancer cells.
Ultimately, the doctors stress that an enlarged prostate is not merely an inconvenience – it might be a warning sign.
So, if you’re experiencing urinary symptoms, speak to your doctor about screening. And if an immediate relative has had prostate cancer, you should get screened earlier in life.