The document discusses the prostate gland's function, common problems associated with aging, and prostate cancer. It highlights the importance of early detection through awareness and medical examinations, as well as the potential for curability if identified early. Factors like family history and age are mentioned as risk indicators for prostate issues.

1. Cancer or Not Cancer ? Dr Ho Siew Hong Consultant Urologist S H Ho Urology and Laparoscopy Centre Gleneagles Hospital

2. Location of Prostate Gland Below urinary bladder Encircles urethra About 25 gm, size of ‘ciku’

3. Function of the Prostate Gland Production of seminal fluid Supplies nutrition to the sperm Without this fluid, the sperm would not survive their journey

4. What happens to the prostate when we get old? Prostate gland begins to age at about age 40-45 years Grows in size Cancer change

5. How common are Prostate problems? ‘ There is an old saying that if you are a man and live long enough, you will eventually have problems with your prostate’ ‘ Prostate enlargement is the commonest growth in the elderly men’ ’ In men above 50 years of age, up to half may have prostate enlargement’

6. Problems with an ‘Old Prostate’ Benign Prostatic Hyperplasia (BPH) - enlargement and obstruction Cancer of the Prostate Infection Inflammation

7. Benign Prostatic Enlargment BPH, BPE Very common Part of aging Results in squeezing of the urine tube

8. How do I know if I have a Prostate problem? Urination problems - Poor flow - Straining - Frequency - Incontinence - Passing more than 2 times in night

9. Complications Urine infection Urine stone Complete urine blockage Kidney failure

10. Prostatitist Pain is the main feature Burning sensation during passage of urine

11. Cancer of the Prostate Less common in Singapore Risk increases with age Usually does not cause much symptoms till cancer is advanced Cancer

12. Symptoms of early Prostate Cancer No pain, No urine complain No blood in urine

13. Other signs of Cancer Tiredness, lethargy Anaemia Loss of appetite Loss of weight Bone pain

14. Risk of cancer Family history of prostate cancer Smoking ? Western diet Not related to prostate enlargement, infection, sexual activities

15. What should I do ? Awareness Early action No self examination method No lump to be felt Consult a doctor

16. Other methods to detect cancer Detail history Current medications Simple abdominal examination Examination of the prostate (by inserting a gloved finger into the back passage)

17. Digital Rectal Examination Nodule Consistency

18. Tests to detect Cancer PSA (Prostate Specific Antigen) - simple blood test - no preparation required - cancer marker - normal <4.0 ug/dL ‘ A high PSA does not necessarily mean that you have cancer of the prostate but it usually means that there is some problem with the prostate’

19. Transrectal Ultrasound and Biopsy

20. Transrectal Ultrasound and Biopsy

21. PAW 2004 Singapore Informed consent form Answer IPSS and IIEF-5 forms Blood for serum total PSA No DRE Those with elevated serum total PSA (>4 ng/dl) advised TRUS-guided biopsy of the prostate Cancer detection rate (based on serum total PSA): 1.2 % (43/3415)

22. Why detect prostate cancer early? Early cancer is potentially curable Cure by surgery or radiation 15 year survival (expected to be a live) - 65% (cancer specific survival 90%) If not treated, 15 year survival - 35% (cancer specific survival 80%)

23. Strategy Awareness Do not deny symptoms Do not accept symptoms as part of aging Routine medical check up - 2 to 3 yearly if between 40 - 50 years old - annual if above 50 years old - annual PSA test if family history of prostate cancer

24. Thank you