Prostate Cancer Treatment in Singapore

• Men with confirmed prostate cancer diagnosis through biopsy
• Patients with localised or locally advanced prostate cancer
• Individuals with adequate general health to undergo treatment
• Men with life expectancy exceeding 10 years for curative treatments
• Patients showing elevated or rising PSA levels with confirmed malignancy
• Those with intermediate to high-risk cancer characteristics
• Men who understand treatment implications and can provide informed consent

• Patients with low-risk, slow-growing prostate cancer
• Men with small tumour volumes confined to the prostate
• Individuals with Gleason score 6 or low-volume Gleason 7 (3+4)
• Older patients where treatment risks may outweigh benefits
• Those with significant medical conditions affecting treatment tolerance

• Severe cardiovascular disease preventing safe anaesthesia (for surgery)
• Blood clotting disorders unresponsive to management
• Previous pelvic radiation (may limit treatment options)
• Uncontrolled medical conditions requiring stabilisation first
• Anatomical factors preventing certain surgical approaches
• Severe urinary obstruction requiring initial management

Thorough assessment is essential. MOH-accredited urologists conduct comprehensive evaluations including physical examination, imaging studies, and laboratory tests to determine the most appropriate treatment approach. Each patient’s unique circumstances guide treatment recommendations, ensuring personalised care that addresses both cancer control and quality of life considerations.

Before treatment begins, comprehensive staging may determine cancer extent through bone scans, CT scans, or PET scans. Blood tests can assess overall health and organ function. Patients meet with specialists to discuss treatment options and potential outcomes. Pre-surgical patients undergo cardiac clearance and anaesthesia assessment. Bowel preparation may be required before surgery or certain radiation protocols. Medications requiring adjustment are identified and managed.

• Surgical Treatment: Radical prostatectomy is performed under general anaesthesia. The surgeon removes the prostate, seminal vesicles, and possibly lymph nodes for examination. Nerve-sparing techniques may help preserve erectile function when cancer location permits. A urinary catheter is placed to allow healing of the bladder-urethra connection.
• Radiation Therapy: External beam treatments occur daily, with each session involving the patient lying still while the linear accelerator delivers targeted radiation. Brachytherapy seed implantation is performed under anaesthesia, with ultrasound guidance for seed placement.
• Hormone Therapy: Initial treatment involves injection administration in clinic settings. Oral medications begin according to prescribed schedules. Regular monitoring aims to ensure treatment effectiveness and manage potential side effects.

Surgical patients recover in hospital with pain management and catheter care education. Radiation therapy patients return home immediately after daily treatments. Brachytherapy patients may experience temporary urinary symptoms requiring medication. Hormone therapy patients receive guidance on managing treatment effects. All patients schedule follow-up appointments for monitoring and support.

Individual results and timelines may vary.

Surgical patients focus on pain management, early mobilisation, and catheter care. Ice packs may help reduce swelling and discomfort. Clear liquids can progress to regular diet as tolerated. Walking may help prevent blood clots and support recovery. Radiation patients may experience mild fatigue or urinary frequency. Brachytherapy patients should monitor for urinary retention requiring medical attention. Pain medication and anti-inflammatory drugs can provide comfort as needed.

Surgical patients may gradually increase activity levels whilst avoiding heavy lifting or straining. Catheter care continues with careful hygiene maintenance. Bowel function typically returns to normal. Radiation therapy continues with daily treatments and symptom management. Skin care becomes important for external beam patients. Hormone therapy effects may begin appearing, including hot flashes or mood changes. All patients should maintain hydration and balanced nutrition supporting healing.

Catheter removal may occur post-surgery, with continence exercises beginning as advised. Patients may regain urinary control through pelvic floor exercises. Erectile function recovery varies and may take time with or without medical assistance. PSA monitoring begins as recommended post-treatment, continuing regularly thereafter. Radiation effects may resolve gradually over time. Hormone therapy patients can adapt to treatment effects with appropriate support and management strategies.

Individual results and timelines may vary.

Urinary incontinence may affect patients initially, particularly following surgery. Men may experience improvement over time through pelvic floor exercises. Erectile dysfunction can occur, with severity depending on age, pre-treatment function, and nerve preservation. Various treatments may help manage this effect. Radiation may cause bowel urgency, frequency, or discomfort during and shortly after treatment. Hormone therapy can cause hot flushes, decreased libido, and fatigue. Weight gain and mood changes may also occur.

Surgical complications can include excessive bleeding requiring transfusion, infection despite preventive measures, or injury to surrounding organs. Deep vein thrombosis or pulmonary embolism may occur despite preventive measures. Radiation can occasionally cause chronic bowel or bladder problems requiring ongoing management. Urethral stricture may develop, necessitating procedural intervention. Hormone therapy may rarely cause cardiovascular events or metabolic complications in susceptible individuals.

Risk minimisation occurs through careful patient selection, meticulous surgical technique, and precise radiation planning. Healthcare professionals aim to recognise and manage complications promptly when they arise. Pre-treatment optimisation of medical conditions may reduce complication likelihood. Individual results and timelines may vary.