Prostate cancer has quietly become one of the most common cancers affecting men in Singapore, even as public awareness often focuses on colorectal or lung cancer. Recent data from the Singapore Cancer Society (SCS) shows that from 2017 to 2021, prostate cancer surpassed colon, rectum, and lung cancers in terms of total cases among men.

Despite awareness campaigns like Prostate Cancer Awareness Month every November, many men remain unfamiliar with the disease, including its risk factors, early signs, and possible ways to reduce the likelihood of developing it.

Understanding the Prostate and Prostate Cancer

The prostate is a small male reproductive gland located below the bladder, near the base of the penis. It produces fluid that combines with sperm to form semen. Prostate cancer develops when normal prostate cells undergo DNA changes, causing abnormal cells to grow uncontrollably. The majority of prostate cancers are adenocarcinomas, originating from the gland’s lining cells.

Who Is Most at Risk?

Prostate cancer primarily affects men over the age of 50. Risk factors include age, diet—especially high intake of red meat and animal fats—and family history. Men with a father or brother diagnosed with prostate cancer face a higher risk, particularly if the relative was diagnosed at a younger age.

Ethnicity also plays a role. In Singapore, Chinese men have roughly twice the risk of developing prostate cancer compared to Malay and Indian men. Certain inherited genetic mutations, such as BRCA1 or BRCA2, may also increase susceptibility.

Medical experts emphasise that many of the strongest risk factors—age, ethnicity, genetics, and family history—cannot be changed. Nonetheless, lifestyle choices may help reduce risk.

Are Younger Men Increasingly Affected?

While doctors in Singapore have noticed more men under 55 being diagnosed with prostate cancer, this trend is largely attributed to greater awareness and earlier screening rather than a genuine shift in disease demographics. More men today seek medical advice when symptoms are mild or when family history indicates higher risk, allowing cancers to be detected earlier and treated more effectively.

Recognising the Symptoms

Prostate cancer often does not cause symptoms in its early stages. When present, warning signs may include difficulty urinating, weak urine flow, frequent urination (especially at night), blood in urine or semen, and pain or burning during urination. Less common symptoms include bone pain, unexplained weight loss, and erectile difficulties.

Experts caution that these symptoms can also result from non-cancerous conditions such as an enlarged prostate, so professional medical evaluation is essential.

Prevention and Early Detection

While absolute prevention is not possible, adopting a healthier lifestyle may help reduce the risk. Recommendations include:

• Eating more vegetables, fruits, and healthy fats while limiting red meat consumption

• Exercising regularly and maintaining a healthy weight

• Avoiding tobacco and limiting alcohol

• Managing chronic conditions like diabetes or obesity

Men with higher risk—due to family history or other factors—should consider regular prostate health checks, including discussions about prostate-specific antigen (PSA) testing, starting from age 50 or earlier if risk factors are present.

Why Early Detection Matters

The prognosis for prostate cancer improves dramatically when detected early. Over 99% of patients with localized disease survive at least five years, compared with just 37% for those with advanced, distant spread. In Singapore, approximately three in ten prostate cancer cases are diagnosed at stage four, highlighting the critical importance of early screening.

Treatment Options

Treatment approaches depend on the stage of the cancer, patient health, and personal preferences. Options for early-stage prostate cancer include surgery, radiation, or focal therapy. Robotic-assisted surgeries are increasingly used, offering minimally invasive removal of the prostate gland.

For advanced cases, treatments may involve hormone therapy, chemotherapy, or immunotherapy. Active surveillance is another option for low-risk patients, allowing careful monitoring of the tumour before initiating treatment.

Takeaway

Prostate cancer is increasingly prevalent among Singaporean men, particularly those over 50. While some risk factors cannot be modified, awareness, healthy lifestyle choices, and regular screening can make a substantial difference in early detection and survival outcomes. Men are encouraged to discuss prostate health proactively with healthcare providers and to remain vigilant even in the absence of obvious symptoms.