Prostate cancer remains one of the most common cancers affecting men globally, including Thailand. And let us be the bearer of bad news today: all men are at risk of developing this type of cancer.
According to the American Cancer Society, an estimated 299,010 new cases of prostate cancer will be diagnosed in the U.S. in 2024 alone. The more disturbing part is that the disease often progresses without noticeable symptoms, earning its grim reputation as “the silent killer.” In Thailand, the story of prostate cancer is much the same. Diagnoses are steadily rising, especially among older men. The good news is that most men diagnosed with prostate cancer don’t die from it.
So, how can you take charge of your health and lower your risk of prostate cancer? Dr. Suntchai Wirotsaengthong, a urologist and head of the M Centre at BNH Hospital, offers his expert insights on prostate cancer screening and treatment for men in Thailand and surrounding countries.
What is prostate cancer?
Prostate cancer develops in the prostate, a small gland located below the bladder and in front of the rectum. This gland plays a vital role in the male reproductive system by producing the fluid that nourishes and transports sperm. Most prostate cancers grow slowly and may not cause significant harm in their early stages. However, more aggressive forms can spread quickly, especially if left undiagnosed.
Is prostate cancer the same as benign prostatic hyperplasia (BPH)?
It’s important to differentiate prostate cancer from benign prostatic hyperplasia (BPH), also known as enlarged prostate. According to Dr. Sutchai, “having BPH doesn’t mean having cancer, although these two diseases can occur together.” This distinction is critical, as BPH is a common condition which certainly does not lead to cancer.
Symptoms of prostate cancer, what should you look for?
One of the reasons prostate cancer is often called “the silent killer” is because the early stages rarely present noticeable symptoms. By the time symptoms appear, the cancer may have already advanced.
You should be vigilant about any changes in your urinary habits or discomfort and consult a healthcare professional if you experience:
- Difficulty starting or maintaining a steady flow of urine
- Increased frequency of urination, particularly at night
- A burning sensation or pain during urination or ejaculation
- Presence of blood in the urine or semen
- Pain in the hips, lower back, or thighs, which could indicate that the cancer has spread to nearby bones
What can you do to prevent prostate cancer?
There’s no one way to avoid prostate cancer. However there are some factors that you can change in order to lower your risk.
Maintain a healthy lifestyle
Lifestyle factors such as diet and exercise influence the likelihood of developing prostate cancer. A diet rich in fruits, vegetables, and omega-3 fatty acids, such as those found in fish, has been associated with a lower risk. Regular exercise and maintaining a healthy weight also play a protective role, as obesity is another risk factor for the disease.
Regular screening
While adjusting your diet and lifestyle is always important, certain risk factors are beyond your control. Age, for one, is a major determinant. Many consider prostate cancer not only a silent killer but also a disease of aging. The likelihood of men developing it increases as you grow older. About two-thirds of all prostate cancers are diagnosed in men ages 65 and older. Race and genetics also play a significant role. Research has shown that men of African descent have a higher risk of developing and dying from prostate cancer. Additionally, if your father, brother, or multiple blood relatives had prostate cancer, your risk is significantly higher as well.
For men with these risk factors, preventing prostate cancer can be challenging. Therefore, the best course of action is regular screening, even if you feel perfectly healthy. As Dr. Sutchai advises, “we would recommend men who are not having any symptoms to start doing the PSA (Prostate-Specific Antigen) test from 50 years old, but for someone who has a family history of prostate issues, testing should start earlier, ideally around age 45.”
With regular screening, you and your doctor may catch prostate cancer early. Early detection is often the difference between a curable cancer and one that becomes much harder to treat. Dr. Sutchai stresses that “the earlier prostate cancer is detected, the better the chances of preventing it from spreading and increasing the likelihood of a full recovery.”
What prostate cancer screening tools are available at BNH Hospital Bangkok?
PSA test
One of the most common methods for prostate cancer screening is the PSA test. PSA is a protein produced by both normal and cancerous cells in the prostate, and elevated levels in the bloodstream may indicate an issue. The generally accepted threshold for concern is a PSA level above 4.0 ng/mL. However, a PSA level below 4.0 ng/mL doesn’t guarantee that a man is free from prostate cancer.
Dr. Sutchai acknowledges some of the concerns men in Thailand have about the PSA test, noting that “many patients are worried because there are a lot of false positives with the PSA test, which is why some choose to avoid it.” Dr. Sutchai points out that activities like recent ejaculation or biking can temporarily elevate PSA levels, causing undue concern. Despite this, PSA testing remains a widely accepted method for detecting prostate cancer, particularly when paired with other diagnostics.
Multi-parametric magnetic resonance imaging (mpMRI)
At BNH Hospital, if a PSA test returns a high result, a multi-parametric magnetic resonance imaging (mpMRI) scan is recommended. This is because a high PSA level doesn’t always indicate cancer. It can also be caused by benign prostatic hyperplasia (BPH) and prostatitis, among other conditions. While Free PSA and the Prostate Health Index (PHI) tests are also available at BNH, Dr. Sutchai explains that these tests can be expensive. Therefore, he typically recommends proceeding with the mpMRI, which provides a more comprehensive evaluation.
The mpMRI is a specialized scan that combines four different imaging techniques to provide detailed pictures of the prostate. This technology helps determine whether cancer is present and reduces the need for unnecessary prostate biopsies.
MRI fusion prostate biopsy
If the mpMRI indicates a higher risk of prostate cancer, the next step is typically an MRI fusion prostate biopsy. This targeted biopsy method is more accurate than traditional random biopsies, which means fewer patients require repeat procedures. The combination of these advanced diagnostic tools at BNH Hospitals provides more precise results to improve the likelihood of early detection and minimise unnecessary interventions.
What treatment options are available for prostate cancer at BNH Hospital Bangkok?
BNH Hospital offers cutting-edge technology and a multidisciplinary team of specialists to treat prostate cancer.
For those diagnosed with non-significant prostate cancer, active surveillance might be the best approach. “Prostate cancer is often slow-growing, and not all cases require immediate treatment,” says Dr. Sutchai. In such cases, the cancer is monitored closely, with treatment only initiated if the cancer shows signs of becoming more aggressive.
For more aggressive cases of prostate cancer, BNH Hospital and its hospital network provide advanced treatment options for men in Thailand, including robotic-assisted surgery and radiation therapy.
Robotic-assisted surgery
This minimally invasive surgery is a preferred option for treating localized prostate cancer. “Robotic surgery offers enhanced precision, particularly in the narrow pelvic region,” Dr. Sutchai notes. “This technology helps preserve important nerves and structures surrounding the prostate, minimizing the risk of complications such as incontinence or erectile dysfunction.” The procedure involves removing the prostate gland through small incisions, with robotic arms enabling highly precise movements. Therefore, it’s less invasive than traditional surgery.
Radiation therapy
Radiation therapy delivers targeted, high-dose radiation to kill cancer cells, either externally or internally (brachytherapy). Thanks to recent advancements, radiation therapy has become more precise. This means that it doesn’t cause damage to surrounding tissues. One such innovation is the use of a gel spacer (SpaceOAR hydrogel) between the prostate and rectum, which protects healthy tissues by minimizing radiation exposure.
Each treatment comes with its own benefits and potential risks, and the choice depends on the individual’s overall health, the stage of cancer, and personal preferences.
There’s no better time than now to get your prostate cancer screening at BNH Hospital
Prostate cancer may be a silent killer, but it doesn’t have to be. Early detection through regular screening and prompt treatment can significantly improve outcomes. BNH Hospital Bangkok stands ready to provide men in Thailand with the best care, offering world-class screening, diagnosis, and treatment for prostate cancer. If you’re over 50 or at high risk, right now is the perfect time to schedule your screening and take the first step towards safeguarding your health.
Get in touch with Dr. Suntchai Wirotsaengthong via WhatsApp at +66 63 4457854 or email dr.suntchai@mcentrebybnh.org.
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