Prostate cancer made headlines earlier this year when former US president revealed his diagnosis after experiencing urinary symptoms. But closer to home, the disease is quietly climbing the ranks in Singapore. According to the Singapore Cancer Society, prostate cancer is now the most common cancer among men in Singapore, surpassing colorectal and lung cancer in cases from 2017 to 2021.

Despite efforts to raise awareness — including Prostate Cancer Awareness Month and screening campaigns — many men remain unaware of what prostate cancer is, its risks, symptoms, and how to reduce their chances of developing it.

What Is Prostate Cancer?

Prostate cancer affects the prostate gland, a male reproductive organ located below the bladder and near the base of the penis. The gland produces a white fluid that mixes with sperm to form semen. According to Dr Wong Siew Wei, medical oncologist at Parkway Cancer Centre, prostate cancer occurs when DNA changes in normal prostate cells lead to uncontrolled growth of abnormal cells. Almost all prostate cancers are adenocarcinomas, which start in the cells that line glands.

Who Is Most at Risk?

Prostate cancer primarily affects older men, with risk increasing substantially after age 50, according to the Singapore Cancer Society. While the exact cause is unknown, several risk factors have been identified:

• Age: Men over 50 are at higher risk.

• Diet: High-fat diets, particularly from red meat and animal products, may increase risk.

• Ethnicity: In Singapore, Chinese men have twice the risk compared to Malay and Indian men, based on data from the National Cancer Centre Singapore.

• Family history and genetics: Men with a father or brother diagnosed with prostate cancer face more than double the lifetime risk, especially if the relative was diagnosed at a younger age. Certain genetic mutations, such as BRCA1/2, may also increase risk.

Dr Wong noted that the best-understood risk factors — age, race, family history, and inherited genes — are not modifiable. However, Dr Jeffrey Tuan from the National Cancer Centre Singapore added that lifestyle factors like diet also play a role.

Are More Young People Getting Prostate Cancer?

While some doctors are seeing more young patients diagnosed with prostate cancer, experts suggest this may be due to increased awareness and screening rather than a true shift in demographics. Dr Shum Cheuk Fan, senior consultant at Woodlands Health, explained that more people are seeking medical opinions earlier, leading to more diagnoses at a younger age. Dr John Yuen from Singapore General Hospital agreed, noting that early-onset prostate cancer remains relatively uncommon, and hereditary factors may play a larger role in younger cases.

Symptoms of Prostate Cancer

Prostate cancer often presents no symptoms in its early stages. However, when symptoms do appear, they may include:

• Difficulty urinating

• Weak urine flow

• Increased urinary frequency, especially at night

• Blood in urine or semen

• Pain or burning during urination

• Bone pain, unexplained weight loss, or erectile dysfunction (less common)

Dr Wu Qing Hui from Raffles Urology Centre emphasised that these symptoms can also be caused by benign prostate enlargement, so it is important to consult a doctor for proper evaluation.

Can Prostate Cancer Be Prevented?

While there is no guaranteed way to prevent prostate cancer, experts agree that a healthier lifestyle can significantly lower risk. Dr Yuen recommends:

• Eating less red meat and more vegetables and healthy fats

• Exercising regularly and maintaining a healthy weight

• Avoiding smoking and limiting alcohol

Dr Wu added that while absolute prevention is not possible, regular exercise, a diet rich in fruits and vegetables, and avoiding tobacco can meaningfully reduce risk. Managing chronic conditions such as diabetes and obesity may also help.

The Importance of Screening and Early Detection

Experts strongly encourage regular screening for men with a family history or higher risk. Men are advised to discuss prostate-specific antigen (PSA) testing with their doctor, starting from age 50 — or earlier if there is a strong family history.

Dr Wong highlighted that early detection significantly improves survival: over 99 per cent of patients with localised prostate cancer survive at least five years, compared to only 37 per cent of those with distant spread. In Singapore, about three in 10 cases are diagnosed at stage four, which leads to a less favourable prognosis.

Treatment Options

Treatment varies based on disease stage, patient health, and individual preferences. For early-stage cancer, options include surgery, radiation, or focal therapy. Robotic-assisted procedures, such as the Da Vinci surgical system, are commonly used. For late-stage cancer, treatment may include hormone therapy, chemotherapy, or immunotherapy. For low-risk cases, active surveillance — closely monitoring the tumour before starting treatment — is also an option.

Final Thoughts

Prostate cancer is a significant health concern for men in Singapore, but early detection and prompt treatment can make a life-saving difference. While some risk factors are beyond our control, adopting a healthier lifestyle and staying informed about screening options are practical steps every man can take. If you're 50 or older — or have a family history of the disease — speak to your doctor about getting tested. Your health is worth the conversation.