Prostate cancer remains one of the most common cancers affecting men in Malaysia, yet awareness and early detection remain significant challenges.
According to available data, prostate cancer is the third most common cancer among Malaysian men. The disease most frequently affects men aged 50 and above, with incidence rising sharply after the age of 60. Despite advances in treatment, at least three in five men are diagnosed at a late stage, when treatment options may become more complex and outcomes less favourable.
“Oftentimes this can be attributed to the lack of routine cancer screening and the tendency to dismiss early warning signs such as urinary difficulties as part of normal aging,” explained Dr Ang Soo Fan, Consultant Medical Oncologist. “When diagnosis occurs late, the consequences of advanced disease such as bone pain, reduced mobility and lower survival rates can have a profound impact on both the patient and their family.”
The Importance of Early Awareness
Many men overlook symptoms in the early stages of prostate cancer. Changes in urinary habits, difficulty urinating, or increased frequency of urination are often attributed to aging rather than potential warning signs.
Dr Ang emphasized that awareness and early engagement with healthcare professionals can significantly improve outcomes.
“A cancer diagnosis is always challenging, and each patient’s concerns are unique,” he said. “Some worry about losing independence or becoming a burden to their loved ones, while others fear that cancer is a death sentence. Part of our role as doctors is to help patients and families understand that with today’s treatment options, even advanced prostate cancer can respond well to therapy.”
With appropriate treatment, many patients can continue to maintain a meaningful quality of life.
A Team-Based Approach to Care
Managing prostate cancer often requires a multidisciplinary team involving oncologists, urologists, nuclear medicine specialists and specialised nurses.
“This coordinated approach ensures that treatment decisions are personalised and well-informed,” Dr Ang explained. “It also allows families to be involved early in discussions, particularly when shared decision-making is important.”
Patients and their families are encouraged to ask questions during consultations and actively participate in understanding treatment options and expected outcomes.
Advances in Diagnosis
Recent developments in nuclear medicine have significantly improved the ability to detect and monitor prostate cancer.
“For most patients, the journey begins with staging, which helps us understand where the cancer is and how far it has spread,” said Dr Alex Khoo Cheen Hoe, Consultant Nuclear Medicine Physician.
One important development is PSMA PET imaging, a highly sensitive imaging technique that detects prostate cancer cells expressing prostate-specific membrane antigen (PSMA).
“PSMA PET imaging has been shown to be far more sensitive than conventional scans,” Dr Khoo explained. “It allows doctors to detect prostate cancer more accurately, even when the tumour is small or difficult to identify.”
This improved diagnostic accuracy helps clinicians determine the most appropriate treatment strategy.
“With PSMA PET imaging, we see what we treat, and we treat what we see,” he said. “This allows doctors to monitor how well treatment is working and can provide reassurance to patients and their families.”
New Treatment Options
In advanced cases where conventional treatments are no longer suitable, newer therapies may offer additional options. One example is radioligand therapy (RLT), which uses targeted radiation to destroy cancer cells while limiting damage to surrounding healthy tissue. Dr Khoo explained that PSMA PET imaging helps guide this therapy by accurately identifying cancer cells.
“For patients, this can mean milder side effects and better quality of life during treatment,” he said.
In some cases, treatment may allow patients to continue working, maintain daily routines, or participate in important family milestones. However, clinicians emphasise the importance of ongoing monitoring.
“Even when treatment is successful, prostate cancer can recur,” Dr Khoo added. “Regular imaging and follow-up care remain essential.”
Looking Ahead
While prostate cancer remains a major health concern in Malaysia, advances in diagnostics and treatment continue to improve patient outcomes.
Raising awareness about symptoms, encouraging earlier medical consultation, and supporting patients through treatment remain key steps in improving survival and quality of life.
With continued collaboration between healthcare professionals, patients and families, prostate cancer care is steadily evolving toward more personalised and effective approaches
