Prostate Cancer Explained: What to Watch for and How It’s Treated

Q: What is prostate cancer?

A: Prostate cancer is a form of cancer that starts in the prostate gland, a small organ that produces seminal fluid to nourish and transport sperm. It is one of the most common cancers in men and often grows slowly without causing symptoms in early-stage.

Q: What causes prostate cancer?

A: Prostate cancer develops when genetic mutations cause cells in the prostate to grow uncontrollably and avoid dying. These abnormal cells can form a tumor, damage surrounding tissues, and potentially spread to other parts of the body (a process called metastasis).

Q: Who is at risk for prostate cancer?

A: Key risk factors include:

• Age: Common in men over 50
• Ethnicity: More prevalent in Black men
• Family history: A close relative with prostate cancer increases risk; having BRCA1 or BRCA2 gene mutations also raises risk
• Obesity: Linked to higher chances of aggressive cancer

Q: What are common symptoms of prostate cancer?

A: Prostate cancer in its early stages may not cause symptoms. As it progresses, symptoms may include:

• Difficulty urinating
• Weak urine flow
• Blood in urine (hematuria) or semen
• Erectile dysfunction
• Bone pain
• Unintentional weight loss

If these symptoms persist, consult a doctor promptly.

Q: How is prostate cancer diagnosed?

A: Screening tests include:

• Digital Rectal Exam (DRE): A gloved finger is used to feel for abnormalities in the prostate
• Prostate-Specific Antigen (PSA) Test: Elevated PSA levels can indicate inflammation, enlargement, or cancer

Q: What happens if prostate cancer screening results are abnormal?

A: If initial screening suggests abnormalities, further diagnostic tests may be recommended to confirm the presence of cancer. These include:

1. Transrectal Ultrasound (TRUS): A small probe inserted into the rectum uses sound waves to produce images of the prostate
2. MRI (Magnetic Resonance Imaging): Provides detailed images and helps guide tissue sampling
3. Prostate Biopsy: A thin needle is used to collect tissue samples from the prostate for laboratory analysis

Q: How is prostate cancer severity determined?

A: To evaluate how aggressive the cancer is, doctors commonly use two tools:

1. Gleason Score: Rates cancer aggressiveness from 6 to 10
   1. 6 = Low-grade
   2. 7 = Medium-grade
   3. 8–10 = High-grade
2. Genomic Testing: Identifies mutations and helps predict disease behavior

Q: How is prostate cancer staged?

A: After diagnosis, imaging tests like MRI, CT scans, PET scans, bone scans, or ultrasound help determine how far the cancer has spread:

• Stage I–II: Localized in the prostate
• Stage III: Spread to nearby tissues
• Stage IV: Spread to distant organs

In some early-stage cases, immediate treatment may not be necessary. Instead, doctors may recommend active surveillance, which involves regular blood tests, rectal exams, and prostate biopsies to monitor the cancer over time. If the cancer shows signs of progression, treatment such as surgery or radiation can then be considered.

Q: What are the treatment options for prostate cancer?

A: Treatment depends on cancer stage, aggressiveness, health status, and personal preferences. Options include:

1. Surgery

• Radical prostatectomy removes the prostate and surrounding tissues

Techniques include:

• Robot-assisted laparoscopic prostatectomy: Uses robotic tools through small abdominal incisions
• Retropubic surgery: A long incision is made in the abdomen to access the prostate; less commonly used

2. Radiation Therapy

• Kills cancer cells with high-energy rays

Options include:

• External Beam Radiation Therapy (EBRT): Delivered over weeks or in higher doses over fewer sessions
• Brachytherapy: Radioactive seeds are implanted into the prostate for continuous low-dose radiation

3. Focal Therapy

• Targets only the cancerous portion of the prostate

Techniques include:

• High-Intensity Focused Ultrasound (HIFU)
• Cryotherapy
• Laser ablation
• Photodynamic therapy

4. Ablation Therapy (Freezing or Heating)

• Destroys prostate tissue using extreme temperatures

Methods include:

• Cryoablation: Freezes cancer cells
• HIFU: Uses focused ultrasound waves to heat and kill cancer tissue

Suitable for small or inoperable cancers and when other treatments aren’t an option

5. Hormone Therapy (Androgen Deprivation Therapy)

• Reduces testosterone, which fuels cancer growth

Approaches include:

• LHRH/GnRH agonists or antagonists: Suppress testosterone production
• Anti-androgens: Block testosterone from reaching cancer cells
• Orchiectomy: Surgical removal of testicles to quickly lower testosterone levels

Used before surgery, for inoperable cancer, or to slow advanced cancer

6. Chemotherapy

• Uses drugs to kill fast-growing cells

Often recommended when cancer has spread, or hormone therapy fails

7. Targeted Drug Therapy

• Focuses on specific mutations (e.g., BRCA) in cancer cells, helps block abnormal growth pathways and promote cancer cell death

Q: Can prostate cancer be cured?

A: Yes. Localized prostate cancer is often curable, especially with early detection. In advanced cases, treatments can manage the disease, relieve symptoms, and extend life expectancy.

Q: When should I see a doctor?

A: You should consider seeing a doctor for prostate cancer screening if you:

• Are over 50 years old
• Have a family history of prostate or breast cancer (including BRCA1/BRCA2 gene mutations)
• Belong to a higher-risk group, such as Black men
• Experience urinary or reproductive changes, bone pain, or unexplained weight loss

Even without symptoms, early screening is recommended for those at higher risk. Regular checkups improve the chances of detecting prostate cancer early when it is most treatable.

At Vejthani Hospital, every prostate cancer case is reviewed with precision through our Multidisciplinary Team (MDT) approach. This means specialists—including oncologists, surgeons, radiologists, pathologists, oncology pharmacists, physiotherapists, psychologists, geneticists, and oncology nurses—collaborate during our weekly Tumor Board Conference to analyze patients’ medical data and develop the most effective, personalized treatment plan. By combining medical expertise with integrated care, our goal is to ensure each patient receives accurate, timely, and comprehensive treatment—enhancing both outcomes and quality of life.

For more information, please contact

Life Cancer Center, Vejthani Hospital
Call: (+66)2-734-0000 Ext. 2720, 2721
English Hotline: (+66)85-223-8888