Dr Tam Wei Lun, Urologist, Ampang Puteri Specialist Hospital

In Malaysia, prostate cancer is the third most common cancer among men, accounting for about 9.5% of all male cancer cases in 2022 (Cancers, MDPI, 2024). According to the National Cancer Registry Report (2017–2021), the lifetime risk of developing prostate cancer among Malaysian men is approximately 1 in 83, but notably higher among Chinese men (1 in 50), with the median age of diagnosis at 70 years.

Meanwhile, community studies reveal that 16.3% of Malaysian men aged 40 and above experience symptoms of prostate enlargement or Benign Prostatic Hyperplasia (BPH) (CodeBlue, 2022). These figures highlight the urgent need for greater awareness and proactive screening, especially for men over 40 or those with a family history of prostate disease.

Understanding the Prostate and Its Common Conditions

The prostate is a walnut-sized gland located just below the bladder and in front of the rectum. Its main function is to produce seminal fluid that nourishes and transports sperm. Although small, the prostate can have a significant impact on men’s health as they age.

The most common prostate conditions include:

• Benign Prostatic Hyperplasia (BPH): A non-cancerous enlargement of the prostate that can cause frequent urination, weak urine flow, or a feeling of incomplete bladder emptying.
• Prostatitis: Inflammation of the prostate that can lead to pelvic pain, fever, or painful urination.
• Prostate Cancer: The most serious of the three. Prostate cancer often develops silently and is typically diagnosed late if men do not undergo regular screening. In Malaysia, more than 60% of prostate cancer cases are detected at advanced stages, when treatment options become more complex (National Cancer Registry, 2021).

Who Is at Risk?

While all men can develop prostate issues, certain factors increase the risk:

• Age: Risk rises significantly after 50 and peaks beyond 70.
• Family History: Having a father or brother with prostate cancer doubles the risk. A sister with breast cancer also indicates a higher familial cancer predisposition.
• Lifestyle: Diets high in red meat and saturated fats, obesity, and smoking are linked to poorer prostate health.
• Ethnicity: Local data show a higher incidence among Chinese men, followed by Malays and Indians (Malaysian Prostate Cancer Registry, 2021). Screening and Early Detection Save Lives.

Early detection remains the cornerstone of prostate health. Screening typically involves:

• Prostate-Specific Antigen (PSA) Blood Test: Measures PSA levels, which may rise in cases of prostate cancer, inflammation, or occasionally in an enlarged prostate.
• Digital Rectal Examination (DRE): A quick and simple bedside test that allows doctors to assess the prostate’s texture and size to detect changes possibly suggestive of prostate cancer.

Men aged 50 and above, or those 45 and above with a strong family history, are encouraged to undergo annual screenings. Early detection dramatically improves outcomes — when detected early, prostate cancer has a 98% five-year survival rate, compared to less than 30% for late-stage cases (Cancers, MDPI, 2024).

Treatment and Lifestyle Management

Treatment for prostate conditions varies depending on the diagnosis. Mild BPH can often be managed with lifestyle changes and medication, while more advanced cases may require surgery if medications fail or complications arise due to an enlarged prostate, such as recurrent urinary tract infections, bladder stones, or renal impairment.

With continuous advances in medical technology, most procedures today are minimally invasive, performed via endourology without skin incisions.

These include:

• Transurethral Resection of the Prostate (TURP)
• Water Vapour Therapy (Rezum)
• Laser procedures

If the condition is cancerous, treatment options differ depending on the stage of the disease and the patient’s overall health.

How to maintain prostate health

• A balanced diet rich in vegetables, tomatoes (lycopene), and omega-3 fatty acids.
• Regular exercise to maintain a healthy body weight.
• Limiting alcohol, quitting smoking, and reducing caffeine consumption.

These strategies are beneficial not only in cancer prevention, including prostate cancer, but also in alleviating symptoms related to prostate enlargement. As a cautionary act, make scheduling annual check-ups with a qualified urologist an important event in your calendar!

References

• Cancers (MDPI, 2024). “Prostate Cancer Trends in Malaysia: Insights from the National Cancer Registry.”

• National Cancer Registry Report 2017–2021. Ministry of Health Malaysia, 2023.

• CodeBlue (2022). “Problems Urinating? Check If You Have an Enlarged Prostate.”