by AMIRUL AZREEN ZULKIFLI aazreen @ revonmedia. com

OST Malaysians are aware about cancer, many of which have the general idea what the subject is all about. Breast, cervix and lung cancer are the most known topics hence it is not a surprise when the level of awareness regarding these is high.

However, the scenario takes a different turn when the topic touches on prostate cancer.

Prostate cancer among Malaysian men is at an alarming rate nevertheless, the awareness towards the danger of the disease is entirely a different story.

Speaking to The HEALTH, KPJ Damansara Hospital Clinical and Radiation Oncologist resident consultant Dr Aminudin Rahman Mohd Mydin provides an in depth understanding towards prostate cancer.

“ Cancer is quite a common condition in Malaysia and it can be triggered by various reasons from the food we eat to the lifestyle of the people. The common cancer we talk about in the public is usually breast cancer, cervical cancer, lung cancer and cologne cancer however, prostate cancer is still a mystery.

“ Cases involving prostate cancer is on the rise due to the aging of Malaysians as it only concerns elderly men above 60 years of age. As men grow older, there is certain changes in the prostate where it will enlarge and lead to a condition called benign prostatic hyperplasia( BPH).”

BPH is a condition where the prostate enlarges and compresses the urine system which will lead to lower urinary tract symptoms( LUTS) which is a very common scenario faced by elderly men.

However, according to Aminuddin, BPH may also lead to prostate cancer.

“ We believed prostate cancer is stimulated by the male hormones( testosterone) and also the tendency is higher among men who are older which will coexist along with BPH.

“ Previously, especially in western countries, prostate cancer is found through incidental findings, whereby the doctors discovered the cancer while doing an autopsy on men who died due to old age.”

Despite that, there are cases of prostate cancer being diagnosed among younger men.

He added:“ Just like how there is a rise of breast and cervical cancer among younger woman, prostate will follow suit.

“ Prostate cancer among younger men might be a rare case however the problem with this scenario is the cancer cells tend to be very aggressive. The aggressiveness is usually determined through a blood test called prostatespecific antigen( PSA).

“ PSA is a protein produced by normal prostate cells. If the PSA is found to be high- the person diagnosed will be labelled as suspected cancer.

“ Although there is a lot of controversies regarding the use of PSA, it is debatable,” he said.

Patient will need to undergo a biopsy- removing needle-core samples from the

Gleason Pattern is the system used to determine the aggressiveness of prostate cancer.

Dr Aminudin Rahman Mohd Mydin

prostate gland in order to confirm the presence of cancer.

Once the cancer is confirmed, the patient need to undergo a scan- MRI, CT scan and bone scan to determine the cancer stage.

Traditionally, MRI and CT scan is the most popular option but according to Aminuddin, there is a new method called a PET scan.

“ It is a process whereby we give injections to detect the cancer. I usually explain to my patients that PET scan is like a colour television whereby the cancer cells can be seen easier compared to CT scan that project black and white images.”

However, the approach today has become more scientific and individualised with the introduction of clinical trials.

Pantai Hospital Kuala Lumpur Pantai Cancer Institute Clinical Oncologist consultant Dr Mastura Md Yusof( pic) explained to The HEALTH that several approaches are being taken to improve the activity and reduce the side effects of chemo.

“ These include novel approaches that target drugs more specifically at the cancer cells-such as liposomal therapy and monoclonal antibody therapy. There are also drugs to reduce side effects like colony-stimulating factors, chemoprotective agents such as Dexrazoxane and Amifostine, and Anti-emetics( to reduce nausea and vomiting),” she said.

Dr Mastura added that the improvements made in the realms of precision( personalised) medicine has allowed better understanding of what mutations are present in tumours to target therapy at them specifically.

“ Targeted therapies are designed to attack, or target known specific abnormalities in a tumour and thus may cause minimum, if any, damage to normal, healthy cells that do not have the abnormality / target.”

“ These treatments are often less toxic than systemic treatment like chemotherapy, which cannot differentiate between cancerous and healthy cells,” she said.

“ In addition to these, there have also been great strides in the development of immunotherapy agents, particularly for melanoma and lung cancer. Clinical trials are ongoing in a continued effort to develop safe and effective immunotherapy agents in multiple cancer sites,” she added.

PRESCRIPTIVE LAUGHTER

Doctor: You’ re here for a check up? Man: Yes. Doctor: Name? Man: Abdullah Doctor: Sex? Man: Two to three times a week. Doctor: No! Male or female? Man: Female lah. It’ s with my wife!