WHAT IS PROSTATE CANCER?
Prostate cancer is the cancer of the prostate gland. The prostate is a walnut-sized gland in between the bladder and the urethra that nourishes and transports sperm. Prostate cancer is the third most common cancer among men in Singapore.
SYMPTOMS OF PROSTATE CANCER
Early stage of prostate cancer has few or no symptoms as the cancer develops slowly. If symptoms appear, they may include difficulty in passing urine, burning sensation while urinating, blood in urine, loss of appetite and/or weight, and lower back pain.
DIAGNOSING PROSTATE CANCER
Prostate cancer is diagnosed through a biopsy. At Urohealth Medical Clinic, we offer MRI Targeted Biopsy of the prostate. Dr Tan Yung Khan, Medical Director and Senior Consultant Urologist of Urohealth Medical Clinic, was the first in Asia to perform the MRI Targeted Fusion Biopsies of the prostate using the UroNav Platform. Using MRI and fusion with ultrasound, targeted biopsies of the prostate are performed. This improves the accuracy of the biopsies and reduces the need for repeat biopsies. However, biopsies are not performed on all men. A biopsy is suggested following some indications such as an elevated PSA (Prostate Specific Antigen), a significant change between consecutive PSA tests and an abnormal rectal examination.
MAGNETIC RESONANCE IMAGING (MRI) TARGETED BIOPSY OF THE PROSTATE (URONAV BIOPSY)
Elevated levels of PSA can be associated with a number of reasons. These include infection, prostatic enlargement but most concerning of them all, prostate cancer.
In the past, to exclude prostate cancer in patients with raised PSA, the patient would be subjected to a systematic or random biopsy of the prostate. This involves 12 biopsies taken from the prostate in a random manner. As such, it is likely possible to miss a cancer and in the event that the biopsy was negative for cancer, the patient would have to undergo another random biopsy if the PSA was still elevated.
In the recent few years, we have discovered that MRI of the prostate can offer valuable insights as to whether an elevated PSA is due to cancer. As such, using MRI and fusion with ultrasound, we can now do targeted biopsies of the prostate. This allows for a quantum leap in accuracy of the biopsies and reduces the need to repeat them. This lowers the risk of infection with repeated biopsies. Targeted biopsy of the prostate can be carried out under sedation or local anaesthesia and patients usually can be discharged on the same day.
WHY DO IT WITH US?
Dr Tan Yung Khan was the first in Asia to perform MRI targeted fusion biopsies of the prostate using the UroNav platform. In his published series, he has shown that in his hands, there has been a significant improvement in the detection of clinically significant prostate cancer. Dr Tan Yung Khan has also gone on to set up the Asia Pacific Centre of Excellence for UroNav guided targeted biopsies and has given talks and run masterclasses for urologists in the region on the use of this system.
TREATMENTS FOR PROSTATE CANCER
Treatment will depend on the type of cancer. Treatments include Radiation (using high-dose x-rays or other particles to kill cancer cells), Hormonal therapy (using hormones to slow or stop cancer growth), Chemotherapy (using drugs to destroy cancer cells) and Surgery to remove the cancer. (Robotic Radical Prostatectomy/Laparoscopic Radical Prostatectomy.
Surgery involves removing the prostate completely.
- ROBOTIC RADICAL PROSTATECTOMY
World reknowned Da Vinci Surgical System is the robotic system that surgeons use to robotically remove the prostate. It is less traumatic and minimally invasive. The Da Vinci Robotic Prostatectomy improves the surgeon’s visualisation, dexterity and precision compared with open or laparoscopic surgery while enabling operation through 1-2cm incisions.
- LAPAROSCOPIC PROSTATECTOMY
This is a minimally invasive surgery procedure to remove cancerous prostate. The surgeon makes a few small incisions compared to one large incision in open surgery leading to less abdominal trauma and a faster recovery process.