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Prostate Cancer Treatment & Surgery in Singapore

Prostate cancer is one of the most treatable cancers when detected early, with numerous effective treatment options available in Singapore. Our MOH-accredited urologist understands the concerns men face when dealing with prostate health and provides comprehensive, compassionate care tailored to individual needs. With modern medical technology and treatment approaches, many men with prostate cancer continue to lead full, active lives.

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Dr Tan Teck Wei

MBBS|DFD (CAW)|MRCS|MMed (Surgery)|FAMS (Urology)

prostate cancer Prostate Cancer Treatment & Surgery in Singapore
Types Causes Symptoms When to see a Urologist Diagnosis Treatment Complications & Prevention FAQ
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Types
Causes
Symptoms
When to see a Urologist
Diagnosis
Treatment
Complications & Prevention
FAQ

What is Prostate Cancer?

Prostate cancer occurs when abnormal cells in the prostate gland grow uncontrollably. The prostate is a walnut-sized gland below the bladder that produces seminal fluid. Prostate cancer often grows relatively slowly and may initially remain confined to the prostate gland.

In Singapore, prostate cancer is the most common cancer among men, affecting approximately 1 in 20 men during their lifetime. While the disease primarily affects older men, with most diagnoses occurring after age 50, younger men with risk factors should also be vigilant about prostate health screening.

Types of Prostate Cancer

Adenocarcinoma

The most common type, accounting for over 95% of prostate cancers. These cancers develop from gland cells that produce prostate fluid. Adenocarcinomas can be classified as acinar (most common) or ductal (more aggressive). The Gleason grade of the adenocarcinomas determine their growth rate.

Other Types

Other types of prostate cancer, such as neuroendocrine and small cell carcinomas are very rare. They are often more aggressive and usually do not cause elevation in prostate specific antigen (PSA) levels.

Causes & Risk Factors of Prostate Cancer

Causes

The exact cause of prostate cancer remains unknown, though researchers have identified several factors that influence its development:

  • Genetic mutations in prostate cells leading to uncontrolled growth
  • Hormonal influences particularly testosterone and dihydrotestosterone (DHT)
  • Inherited genetic changes including BRCA1 and BRCA2 mutations
  • Environmental factors that may trigger cellular changes

Risk Factors

  • Age: Risk increases significantly after 50, with most diagnoses occurring after 65
  • Family History: Having a first-degree relative (father or brother) with prostate cancer approximately doubles your risk.
  • Obesity: Associated with a greater likelihood of developing more aggressive or advanced cancer.
  • Diet: Diets high in red meat and high-fat dairy products may be linked to increased risk.

Signs & Symptoms of Prostate Cancer

Image An Asian business man urinates in bathroom, person

Early Stage

  • Often asymptomatic in early stages, underscoring the importance of regular screening
  • Subtle urinary changes, such as increased frequency or weak stream
  • Mild discomfort during urination
Image prostate cancer advanced

Advanced Stage

  • Frequent urination, particularly at night (nocturia)
  • Difficulty starting or stopping urine flow
  • Weak or interrupted urine stream
  • Blood in urine or semen
Image prostate cancer late stage

Late Stage

  • Bone pain, particularly in the spine, hips, or ribs
  • Weakness or numbness in the legs or feet
  • Loss of bladder or bowel control (possible spinal cord compression)
  • Unexplained weight loss
  • Persistent or severe fatigue

Many early-stage prostate cancers produce no symptoms, which is why regular screening is crucial for men at risk. Symptoms often only appear when the cancer has grown large enough to affect urinary function.

Experiencing these symptoms?
Don’t wait for them to worsen

Schedule a consultation with our MOH-accredited urologist for an accurate diagnosis and personalised treatment plan.

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When to See a Urologist

Consult a urologist immediately if you experience blood in your urine or semen, difficulty urinating, or persistent bone pain. These symptoms require prompt evaluation. Men over 50 should discuss prostate cancer screening with their doctor, while those with family history should consider screening from age 45. During your first consultation, the urologist will review your medical history, perform a physical examination including a digital rectal exam (DRE), and may order blood tests including PSA levels. The consultation provides an opportunity to discuss your concerns and understand your risk factors. Early detection improves treatment outcomes and provides more treatment options.

Diagnosis & Testing Methods

  • Digital Rectal Examination (DRE)

    A physical examination that allows the doctor to feel for abnormalities in prostate texture or size.

  • Prostate-Specific Antigen (PSA) Blood Test

    A PSA test measures a protein produced by the prostate. Elevated PSA levels may indicate cancer, though other conditions can also cause increases.

  • MRI scan of the Prostate

    MRI scans can visualise the location and extent of abnormal prostate tissue, helping to guide biopsy procedures.

  • PSMA PET-CT Scan

    A specialised imaging test used if there is concern the cancer may have spread. It helps identify cancerous activity throughout the body by targeting prostate-specific membrane antigen.

  • Prostate Biopsy

    This involves taking small tissue samples from the prostate using ultrasound guidance. The samples are examined to confirm the presence of cancer and determine the Gleason grade, which indicates aggressiveness. Results typically take 5–7 days.

Prostate Cancer Treatment Options

Treatment for prostate cancer in Singapore offers multiple approaches tailored to cancer stage, aggressiveness, and patient preferences. The choice depends on age, overall health, and personal values regarding quality of life.

Active Surveillance

For men with low-risk, slow-growing prostate cancer, especially in older individuals or those with other health issues, active surveillance may be appropriate. This approach involves regular PSA tests, digital rectal examinations (DRE), periodic MRI scans, and biopsies to monitor the cancer closely. Treatment is initiated only if the cancer progresses.

Robot-assisted Radical Prostatectomy

This involves the complete surgical removal of the prostate gland, and sometimes nearby lymph nodes. This is a common treatment for localised prostate cancer and the robot-assisted technique is now the standard option. Robot-assisted surgery is an advanced minimally-invasive surgery, with advantages over open surgery including reduced pain, lower blood loss, and faster recovery after surgery. Hospital stay is typically 1–3 days, with full recovery in 6–8 weeks.

Retzius-sparing Robot-assisted Radical Prostatectomy

This is a technical modification of the conventional robot-assisted radical prostatectomy, and Dr Tan is one of a handful of urologists in the region performing this. In retzius-sparing surgery, the bladder is left untouched in its original position, and the prostate gland is completely removed from the small space between the bladder and the rectum. By keeping the bladder and its support structures in place, studies have shown that this technique results in the fastest return of urinary continence after surgery. In addition, nerve-sparing can be performed in suitable patients, increasing the chances of recovery of erectile function after surgery.

Radiation Therapy

Modern radiation techniques target cancer cells while minimising damage to healthy tissue. Options include:

External beam radiation therapy (EBRT): Delivered from outside the body, typically over several sessions. Techniques like IMRT and proton therapy offer enhanced precision.

Brachytherapy: Involves implanting radioactive seeds directly into the prostate to deliver localised radiation over time.

Focal Therapy

Newer approach treating only the cancerous area while preserving healthy prostate tissue. Options include high-intensity focused ultrasound (HIFU) and cryotherapy. It is suitable for select patients with localised, intermediate-risk cancer. This treatment aims to maintain quality of life while controlling cancer, but is still not considered the standard of care compared to radical prostatectomy or radiation therapy.

Hormonal Therapy (Androgen Deprivation Therapy)

Prostate cancer usually relies on testosterone to grow. This treatment reduces testosterone levels or blocks its effect to slow cancer progression. Options include LHRH agonists (injections every 1–6 months), anti-androgens (daily tablets), or surgical castration (removal of both testicles). Commonly used for advanced or metastatic prostate cancer. Side effects may include hot flushes, reduced libido, and bone density loss.

Chemotherapy

Chemotherapy involves drugs that kill rapidly dividing cells, including cancer cells. It is typically used when the cancer has spread outside the prostate and no longer responds to hormone therapy. Common drugs include docetaxel and cabazitaxel, given intravenously every 3 weeks.

Every patient’s condition is unique

Our MOH-accredited urologist will assess your specific situation and recommend the most suitable treatment approach for you.

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Complications If Left Untreated

Untreated prostate cancer can progress from a localised, manageable condition to life-threatening disease. Initially confined to the prostate, cancer cells may spread to nearby tissues including the bladder and rectum, causing urinary obstruction and bowel problems. Cancer commonly spreads to bones, particularly the spine, pelvis, and ribs, causing severe pain and increasing fracture risk.

Metastatic prostate cancer can compress the spinal cord, potentially causing paralysis if not treated urgently. The cancer may spread to lymph nodes and distant organs including liver and lungs. Without treatment, advanced prostate cancer reduces life expectancy and quality of life. Even advanced cancer can often be managed effectively with modern treatments, emphasising the importance of not delaying medical consultation.

Prostate Cancer Prevention

While prostate cancer cannot be completely prevented, certain lifestyle modifications may reduce risk. Maintaining a healthy diet rich in vegetables, particularly tomatoes (containing lycopene) and cruciferous vegetables, shows protective benefits. Limiting red meat and high-fat dairy consumption may help. Regular physical activity, at least 30 minutes most days, supports overall prostate health.

Maintaining healthy weight through diet and exercise is important, as obesity is linked to more aggressive cancers. Some studies suggest foods rich in omega-3 fatty acids, such as fish, may be protective. Regular screening remains an effective prevention strategy, allowing early detection when treatment is usually successful. Men with family history should discuss genetic counselling and enhanced screening protocols with their doctor.

drinfo

Dr Tan Teck Wei

MBBS (S’pore)

DFD (CAW)

MRCS (Edin)

MMed (Surgery)

FAMS (Urology)

A Senior Consultant Urologist in Singapore, Dr Tan Teck Wei specialises in the management of complex urological cancers involving the kidneys, prostate, and bladder.

He is fellowship-trained in open, laparoscopic and robotic surgery. He also specialises in the management of other urological conditions including:

  • Prostate Enlargement
  • Recurrent Urinary Tract Infections
  • Stones

To date, Dr Tan Teck Wei has been involved in more than 500 robot-assisted surgeries, building up his volume of cases from his fellowship training days and cementing his expertise in robotic surgery.

Dr Tan Teck Wei believes in the holistic management of his patients, and seeks to journey with them from diagnosis to cure.  Dr Tan is effectively bilingual in English and Mandarin, making him a popular choice with the young and old, as well as international patients.

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    Frequently Asked Questions

    At what age should I start prostate cancer screening in Singapore?

    Most men should begin discussing prostate cancer screening with their doctor at age 50. Men at higher risk, including those with family history of prostate cancer or of African descent, should consider screening from age 45. Screening involves a PSA blood test and may include a digital rectal examination. Your doctor will help determine the appropriate screening schedule based on your individual risk factors and initial test results.

    Will prostate cancer treatment affect my sexual function?

    Treatment effects on sexual function vary depending on the type of treatment and individual factors. Nerve-sparing surgical techniques and modern radiation therapy aim to preserve erectile function when possible. Many men experience temporary changes that improve over time with appropriate rehabilitation. Your urologist will discuss potential impacts and available treatments to help maintain sexual health. Options include medications, devices, and other interventions to support recovery of sexual function.

    How long is the recovery period after prostate surgery?

    Recovery time varies based on the surgical approach used. For robot-assisted surgery, most patients stay in hospital for 1-2 days and return to light activities within 2-3 weeks. Complete recovery usually takes 6-8 weeks. Catheter use is required for about a week post-surgery. Your surgeon will provide specific recovery guidelines including activity restrictions, pelvic floor exercises, and follow-up schedules to ensure optimal healing.

    Can prostate cancer come back after treatment?

    While many men are cured with initial treatment, prostate cancer can recur. Risk of recurrence depends on initial cancer stage, Gleason score, and PSA levels. Regular follow-up with PSA monitoring helps detect any recurrence early when additional treatment options remain effective. If cancer returns, treatment options include radiation therapy after surgery, hormone therapy, or other approaches depending on the recurrence pattern.

    What’s the difference between prostate cancer and BPH?

    Benign prostatic hyperplasia (BPH) is non-cancerous prostate enlargement common in ageing men, while prostate cancer involves malignant cell growth. Both can cause similar urinary symptoms, but BPH doesn’t increase cancer risk or spread to other body parts. Proper medical evaluation can distinguish between these conditions. Some men may have both conditions simultaneously, requiring comprehensive management approaches.