Consultant urologist Dr George Lee Eng Geap, or a.k.a Dr G, delves into the treatments available for late stage prostate cancer.
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LifestyleTranscript
00:00So the last section we're doing is the last stage of prostate cancer.
00:06Sadly, in Malaysia, about two-thirds of men presented with stage 3 prostate cancer,
00:12meaning that the cancer has already spread to the lymph node
00:16or has spread to other organs, primarily the bones.
00:20What seems to be the problem?
00:28It's because patients presented late.
00:31And that's the reason why they actually get into such trouble.
00:35So if the patients actually started getting regular check-ups such as PSA blood tests,
00:41then something like that will change quite dramatically,
00:44like in high-resource countries such as USA and UK,
00:49where only one-third of the patients probably presented with prostate cancer at late stages.
00:56Let's talk about treatment itself.
00:59So when people start thinking about late-stage cancer, they think about death.
01:04However, prostate cancer is quite peculiar,
01:07in the sense that it is controlled by hormone,
01:11and when men are deprived of testosterone, then the cancer stays dormant for a long time.
01:18What it means is that even if you are presented with late-stage prostate cancer,
01:23you do not go into a doom period of short-term life expectancy and subsequently death,
01:32and a lot of prostate cancer can be controlled by hormonal suppression.
01:37So the hormonal suppression can be done several ways.
01:40The old way of doing it is castration,
01:43meaning that we remove both testicles to deprive the men of testosterone.
01:48Other newer method is injecting a type of medicine called LHRH agonist.
01:56LHRH is a hormone produced by the brain.
02:00If you inject this agonist, then it will trick the brain to suppress the production of such hormone,
02:07as a result and shrinkage and the reductions of the production of testosterone from the testicle.
02:14Apart from that, other way of doing it is to take medicine which is an anti-androgen,
02:20and then this medicine can suppress it.
02:23Although it sounds quite cruel that you castrate a man or medically castrate a man,
02:29the reality is that men will experience the same problem as women when they undergo menopause.
02:36So the hot flushes, night sweating will all emerge just like how it happens in a woman.
02:42So it's not too dramatic.
02:44However, things to take into account will be osteoporosis,
02:48because without the testosterone, a man's bone become quite brittle,
02:52and therefore we need to protect the bone strength.
02:55For men who subsequently develop castration-resistant prostate cancer,
03:01then there are several drugs that are available to control it,
03:04but the end stages of cancer itself can be quite horrible
03:08in the sense that it will cause a man to be anemic, fracture bone,
03:13constipation because of enlarged prostate causing obstruction of the bowel,
03:17and also retention of urine.
03:20So obviously to avoid all these, the way is to get screened,
03:24and to avoid late stage prostate cancer, and to avoid castration altogether.
03:30So for the month of December, I think we're going to make it a bit light-hearted.
03:34We're going to deal with myth of cancer and also other men's health subjects.
03:39The first one that we're going to deal with is vasectomy associated with prostate cancer.
03:45If you're concerned about such myth, and you're interested to find out,
03:49stay tuned for next week's Putting Dr. G on the Spot.
04:00For more information visit www.FEMA.gov