Prostate Cancer

How is prostate cancer treated? 

Treatment for prostate cancer depends on several factors including the patient’s age, medical conditions, significant illnesses, prostate-specific antigen level, digital rectal examination results, aggressiveness of the cancer and spread of disease. 

An individual with prostate cancer should be assessed by a multi-disciplinary team of specialists to determine which modality of treatment is best for them. Prostate cancer treatment requires the involvement of different specialists – urologists, interventional radiologists, nuclear medicine physicians, medical oncologists, radiation oncologists and palliative medicine specialists. Such multi-disciplinary care is available at SingHealth healthcare institutions. It is important to discuss all the possible treatment choices, including what to expect and possible side effects, to help you make an informed decision.

Types of treatment

• Active surveillance
  

• Men with early-stage prostate cancer, that is slow-growing and causing little or no symptoms, may not need immediate treatment. In such cases, doctors may advise waiting and observing to see if the cancer progresses before starting any treatment. Active surveillance may include regular bloods tests for prostate-specific antigen (PSA), digital rectal examination, imaging investigations and repeat biopsies if required.
  

• Surgery
  

• Surgery to treat prostate cancer is known as prostatectomy. It involves removing all or part of the prostate gland. Surgery is usually offered to men with early-stage disease or cancer that is confined to the prostate, who do not have other serious health problems.
  
  In radical prostatectomy, the entire prostate gland and other nearby tissues (e.g. surrounding structures and lymph nodes) are surgically removed.
  
  Another approach is the robotic-assisted laparoscopic radical prostatectomy. This is a minimally invasive surgical technique, where the surgeon makes several small incisions in the lower abdomen and uses instruments attached to a mechanical device, known as “robotic arms”, to perform the surgery.
  
  Tissues that have been surgically removed are sent to the pathology lab to be examined to determine how advanced the prostate cancer is, the risk of cancer recurrence and if additional treatment is necessary.