FEBRUARY 23, 2022
Prostate Exams
Apart from skin cancers, prostate cancer is the most common cancer among males. In fact, according to the American Cancer Society, about one in seven men will be diagnosed with prostate cancer during his lifetime; the older a man is, the higher his risk, as prostate cancer is much more common after the age of 50, and is found in about six out of 10 men aged 65 or older. Luckily, this type of cancer can grow slowly, and most men diagnosed with prostate cancer do not die from it.
When it comes to screening for prostate cancer, DR COLIN KOH of Complete Healthcare International (CHI) says it’s a very personal choice based on individual risks and concerns, especially for those who know a cancer sufferer or have a family history of the disease.
“There is much controversy regarding prostate cancer screening. The main issue is that prostate cancer is generally slow-growing and is often without symptoms. Hence it’s possible for a man to die from other illnesses like a heart attack, a stroke or another cancer before he even develops symptoms of prostate cancer,” says Dr Koh.
Prostate Exams
Apart from skin cancers, prostate cancer is the most common cancer among males. In fact, according to the American Cancer Society, about one in seven men will be diagnosed with prostate cancer during his lifetime; the older a man is, the higher his risk, as prostate cancer is much more common after the age of 50, and is found in about six out of 10 men aged 65 or older. Luckily, this type of cancer can grow slowly, and most men diagnosed with prostate cancer do not die from it.
When it comes to screening for prostate cancer, DR COLIN KOH of Complete Healthcare International (CHI) says it’s a very personal choice based on individual risks and concerns, especially for those who know a cancer sufferer or have a family history of the disease.
“There is much controversy regarding prostate cancer screening. The main issue is that prostate cancer is generally slow-growing and is often without symptoms. Hence it’s possible for a man to die from other illnesses like a heart attack, a stroke or another cancer before he even develops symptoms of prostate cancer,” says Dr Koh.
“There is much controversy regarding prostate cancer screening. The main issue is that prostate cancer is generally slow-growing and is often without symptoms. Hence it’s possible for a man to die from other illnesses like a heart attack, a stroke or another cancer before he even develops symptoms of prostate cancer,” says Dr Koh.
Many feel that screening for signs of cancer at an early stage, before any symptoms appear, prevents any possible risks or The prostate, a walnut-sized gland located directly below the bladder and in front of the rectum, is part of the male reproductive system that produces secretions to protect sperm. WHAT EXACTLY IS A PROSTATE? discomfort – the “better safe than sorry” attitude. “Advocates of screening for prostate cancer would do a digital rectal examination (DRE) and a prostate-specific antigen (PSA) blood test. They believe that early detection is crucial to finding cancer confined within the gland, and reducing complications and mortality. When symptoms develop, or when DRE results become positive, such cases might have already advanced beyond the prostate,” says Dr Koh.
Others, however, feel that screening for prostate cancer does more harm than good, since this type of cancer is usually not life-threatening. For example, men may go through unnecessary follow-up tests, biopsies and other treatments, and experience anxiety over a false-positive PSA test.
After all, raised PSA levels do not confirm prostate cancer. A prostate infection can raise PSA, for instance, and, in that case, your doctor would prescribe a course of antibiotics before rechecking the prostate. Dr Koh notes that further testing may include a prostate ultrasound to detect any prostate enlargement or suspicious growths within the gland. He says specialised blood tests like the Prostate Health Index (PHI) may also be ordered to determine the likelihood of cancer before doing a biopsy, which can confirm whether or not cancer exists.
According to Dr Koh, if cancer is confirmed, treatment options are divided into early stage and advanced stage. If the cancer is small and contained within the prostate gland, it’s usually managed either by “watchful waiting” (regular monitoring of PSA blood levels), radiation therapy (implanting radioactive seeds into the prostate, or radiotherapy involving radiation beams aimed close to the cancer) or surgery in which the prostate is removed. If the cancer is more aggressive or advanced, Dr Koh says the patient may require a combination of radiotherapy and hormone therapy.
Every case is unique and needs to be discussed with a doctor, notes Dr Koh. “All these treatment options have their advantages and disadvantages, and must be customised.”
“There is much controversy regarding prostate cancer screening. The main issue is that prostate cancer is generally slow-growing and is often without symptoms. Hence it’s possible for a man to die from other illnesses like a heart attack, a stroke or another cancer before he even develops symptoms of prostate cancer,” says Dr Koh.
Many feel that screening for signs of cancer at an early stage, before any symptoms appear, prevents any possible risks or The prostate, a walnut-sized gland located directly below the bladder and in front of the rectum, is part of the male reproductive system that produces secretions to protect sperm. WHAT EXACTLY IS A PROSTATE? discomfort – the “better safe than sorry” attitude. “Advocates of screening for prostate cancer would do a digital rectal examination (DRE) and a prostate-specific antigen (PSA) blood test. They believe that early detection is crucial to finding cancer confined within the gland, and reducing complications and mortality. When symptoms develop, or when DRE results become positive, such cases might have already advanced beyond the prostate,” says Dr Koh.
Others, however, feel that screening for prostate cancer does more harm than good, since this type of cancer is usually not life-threatening. For example, men may go through unnecessary follow-up tests, biopsies and other treatments, and experience anxiety over a false-positive PSA test.
After all, raised PSA levels do not confirm prostate cancer. A prostate infection can raise PSA, for instance, and, in that case, your doctor would prescribe a course of antibiotics before rechecking the prostate. Dr Koh notes that further testing may include a prostate ultrasound to detect any prostate enlargement or suspicious growths within the gland. He says specialised blood tests like the Prostate Health Index (PHI) may also be ordered to determine the likelihood of cancer before doing a biopsy, which can confirm whether or not cancer exists.
According to Dr Koh, if cancer is confirmed, treatment options are divided into early stage and advanced stage. If the cancer is small and contained within the prostate gland, it’s usually managed either by “watchful waiting” (regular monitoring of PSA blood levels), radiation therapy (implanting radioactive seeds into the prostate, or radiotherapy involving radiation beams aimed close to the cancer) or surgery in which the prostate is removed. If the cancer is more aggressive or advanced, Dr Koh says the patient may require a combination of radiotherapy and hormone therapy.
Every case is unique and needs to be discussed with a doctor, notes Dr Koh. “All these treatment options have their advantages and disadvantages, and must be customised.”
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Introduction
Resident Physician Dr Elizabeth Heah graduated from the University of Manchester in 2018. She has since been practicing in Singapore, with experience from Singapore restructured hospitals in the departments of General Surgery, Internal Medicine and Obstetrics and Gynaecology. She is passionate about preventative medicine and adopts a holistic approach to healthcare. Outside of medicine she enjoys practicing yoga, interior design and pottery. |
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Introduction
Consultant Radiologist He was awarded the Singapore Armed Forces Medical Scholarship in 2001 to study Medicine at the National University of Singapore and attained his MBBS in 2006. Dr Low then trained and obtained his post-graduate qualifications in Diagnostic Radiology FRCR (UK) and MMed (Spore) in 2012. In 2016, he was awarded the Health Manpower Development Program (HMDP) fellowship by the Singapore Armed Forces to train in Musculoskeletal and Interventional Radiology at Vancouver General Hospital and the University of British Columbia in Canada. Under the mentorship of Prof Peter Munk, Prof Bruce Forster and Prof Hugue Ouellette, the fellowship centred on advanced musculoskeletal imaging, sports imaging and musculoskeletal interventions. Upon his return to Singapore and during his tenure as Consultant at Tan Tock Seng Hospital, he started several interventional programmes for tumour ablations (for both palliative and benign), vertebroplasties, hydrodilatation clinics for adhesive capsulitis and other musculoskeletal ultrasound-guided procedures. |
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Introduction
Consultant Radiologist Clinical Interest & Subspecialty: Neuroradiology (Brain, Head & Neck, Spine) and Neurointervention Dr Santhosh Raj is a Consultant Radiologist with 20 years of experience in radiology. He graduated from Universiti Sains Malaysia in 2002 and obtained the Fellowship of the Royal College of Radiologists (U.K.) in 2008. Upon completing the Advanced Specialist Training (AST) in Singapore in 2013, he joined the Neuroradiology subspecialty team at Singapore General Hospital. In 2015, he completed his training in Neurointervention at the National Institute of Clinical Neurosciences in Budapest, Hungary, through the SingHealth Health Manpower Development Program (HMDP) fellowship. In addition to his routine work, Dr Santhosh also reports MRI Brain Volumetry scans that are used to assess structural brain degeneration, particularly Alzheimer’s disease and related dementias (ADRD). He also reports Ultra Low-Dose (Submilisievert) CT Lung, which allows lung screening at doses lower than routine lung screening CT scans. Other innovative imaging scans that he developed in the past include Intracranial Vessel Wall Imaging (3T MRI), an optimized CT Arterio-Venography (CTAV) of the brain, and an optimized Multiphasic CT Angiography of the Neck and Brain (acute stroke management). His past appointments include Deputy Director of Vascular and Interventional Radiology (SGH), and Director of Radiology Training (SGH). He was also Clinical Lecturer at the Yong Loo Lin School of Medicine (NUS), and Adjunct Assistant Professor at Duke NUS. Dr Santhosh is particularly interested in imaging informatics and artificial intelligence (AI). He is passionate about teaching and developing innovative imaging scans. He also loves to walk and spend quality time with his family. |