The reasons are layered: stigma, uncertainty, fear of invasive procedures, or the assumption that “it’s probably nothing”. But the data tells a different story: prostate cancer is now the third most-common cancer among Malaysian men, with nearly 70% of cases only detected at advanced stages.

While women are generally introduced to reproductive health check-ups from a younger age, men are far less likely to engage in routine screenings. Many only seek help once symptoms become disruptive or difficult to ignore.

For some, opening up about urinary or prostate health feels uncomfortably personal, while the idea of a physical examination can trigger anxiety or embarrassment.

“I think there is an element of stoicism among men, where health issues are often brushed aside with the belief that they will resolve on their own,” said consultant urologist Dr Yeoh Wei Sien.

“Many also believe they are not at risk – what we call low perceived susceptibility – so they don’t see their symptoms as abnormal or worth medical attention.

“By the time they do start to appear, some would have already turned to the internet for answers, or tested out home remedies or supplements recommended by friends. These approaches might delay proper diagnosis and, in some cases, make the condition worse.”

Cultural expectations also play a role. “Men are often expected to appear strong, which makes talking about health issues such as prostate care harder, as it may seem too personal or uncomfortable,” Yeoh added.

What happens during a urology appointment?

One of the biggest deterrents for men is simply not knowing what to expect. The term “prostate check” often evokes anxiety, largely because of its association with the digital rectal exam (DRE). Yet, modern urology consultations are far more discreet, professional, and patient-focused than many realise.

Yeoh explains that a typical appointment begins with a conversation: “We start by asking about symptoms, lifestyle, and general health. If the prostate appears to be the main concern, we then focus on urinary patterns and risk factors.

“If necessary – and always with the patient’s consent – a physical exam may be performed, which can include a rectal exam to assess the size and consistency of the prostate gland.”

While the DRE remains a useful diagnostic tool, Yeoh says it is not as daunting as one might think. “During an appointment, we always explain what will happen beforehand, and keep the process as quick and gentle as possible. Most patients even walk away saying it wasn’t nearly as uncomfortable as they had imagined.”

Importantly, prostate care today extends well beyond physical exams. Depending on the case, doctors may recommend lab tests, imaging, or specialised assessments.

Rethinking prostate care

For years, prostate health was treated as an isolated issue. Yet the prostate is closely linked to broader aspects of men’s health – from urinary function to sexual performance.

“The prostate is part of the reproductive system. While treatment for prostate enlargement can sometimes lead to erectile dysfunction (ED), not all ED is prostate-related,” Yeoh noted.

“Many men know the prostate affects urination and reproduction, but they don’t always understand how it connects to overall health and quality of life. Left untreated, poblems with the prostate could lead to the infection of other bodily systems.”

Early warning signs should not be ignored, he added. “Slow urination, recurrent infections, waking up too often at night to void, or seeing blood in the urine are all reasons to seek consultation.”

Encouragingly, urology care itself has evolved. Yeoh pointed out that medications are now more specific with fewer side effects, while surgical options are increasingly minimally invasive.

Ultimately, prostate care goes beyond just getting diagnosed – it’s about empowering men to take charge of their health. Through public education and open dialogue, urology experts seek to normalise conversations around prostate health and encourage proactive care.

“Malaysia currently has no national prostate-cancer screening programme,” Yeoh said. “However, men aged 45-50 – especially those with a family history – should consider early testing.

“The earlier it’s diagnosed, the more options we have, often with minimal disruption to daily life. Early detection offers the best chance for effective treatment or even a cure.”