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Prostate Cancer | Movember 2020

Movember is a month to create awareness for Men’s health. 

Why do we need to create this awareness? 

There are an increasing number of men suffering from specific conditions unique to men like prostate cancer, testicular cancer and also mental illness. On top of them there are more men dying from these conditions. 

In this article, we will touch on prostate cancer.

Prostate cancer

Prostate cancer is the 3rd most common cancer diagnosed in males in Singapore and accounts for 12% of all male cancers diagnosed from 2008 to 2018. According to the Singapore Cancer Registry report from 2015, the incidence has been increasing from 9.7 per 100,000 previously to 28.5 per 100,000 in 2008-2012.

Males in Singapore have a higher rate of prostate cancer than their counterparts in Asia, for example, China, Japan and India. Locally, Malay and Indian men appear to have a lower risk of prostate cancer as compared to Chinese men at about 15.9-17.9 per 100,000 as compared to 25.6 per 100,000.


What is Prostate Cancer?

Prostate cancer is cancer that occurs in the prostate.

The prostate is a walnut shaped gland located just below the bladder surrounding the urethra. The prostate’s function is to produce seminal fluid. This fluid is necessary to nourish and transport sperm that is produced in the testes.


Who is at risk?

Prostate cancer can affect any man. However some are at higher risk than others.

These include:

  • Men above 50. The risk of prostate cancer increases with age especially after the age of 50. More than 80% are diagnosed in people 65 years and older.
  • Family history of prostate cancer. 20% of prostate cancers occur in men who had a history of prostate cancers in their family. This type of prostate cancer is due to inherited genes and shared environmental or lifestyle factors. Having a brother or father with prostate cancer increases your risk 2 to 3 times. Having a sister or mother with breast or ovarian cancer also increases your risk.
  • Ethnicity – Men of African ancestry are at higher risk of prostate cancer compared to men of other races. 
  • Obesity – Men with BMI higher than 27.5 are at a higher risk for many different types of cancers including prostate cancer. Lack of physical activity and poor eating habits are also contributing factors.

Prostate Cancer Screening

  • Prostate Specific Antigen (PSA): This is a blood test that looks out for a protein released by the prostate. This level is usually elevated in benign prostate enlargement, prostate cancer or prostate inflammation.
  • Digital rectal examination: This is a medical examination performed by the doctor. The doctor will place his finger gently in the back passage (rectum) to feel the texture and size of the prostate. In prostate cancer it may be enlarged or have abnormal nodules.
  • Family history: The doctor will ask for any history of prostate, ovarian or breast cancer in the family.
  • Prostate Biopsy: An ultrasound guided biopsy is performed to determine the presence of cancer. This is usually performed if any of the previous screenings mentioned above is suspicious for prostate cancer.

Prostate Cancer Screening Singapore


How do we prevent it?

Fruit and vegetables: Consuming a wide variety of fruits and vegetables has moderately good evidence to reduce prostate cancer risk. Garlic and spring onions has been shown to boost immune system and reduce prostate cancer risk

Lycopene, green tea, soy products and pomegranate: Some limited evidence has shown that the above foods may reduce prostate cancer risk. You can obtain lycopene in cooked or processed tomatoes, watermelon and guavas.

Maintain a healthy weight: Obesity is a known risk factor for prostate cancer. Obese men are at higher risk for developing aggressive forms of prostate cancer.

Stay active: Higher physical activity shows a small to moderate protective effect against developing prostate cancer especially advanced  cancer. Exercise helps to boost our antioxidant defense and fight cancer causing changes in the body.

Reduce fat intake: A higher fat intake has been associated with a higher risk of prostate cancer and its progression. By reducing your fat intake from animal and dairy sources, it can improve cardiovascular health and reduce risk of prostate cancer.

Quit Smoking: Smoking has a significant impact on occurrence of prostate cancer that can lead to death. Smokers were 20% more likely to develop prostate cancer compared to non smokers. By not starting or quitting smoking, it reduces your risk of getting advanced prostate cancer.

With the above information, I hope it can help you make the right decision in prevention and screening for prostate cancer. Do consult your doctor if you would like to screen for prostate cancer or if you have any urinary symptoms.

Other articles on prostate health: Prostatitis, Enlarged Prostate What You Need To Know, Prostate Cancer Screening & What you need to know about prostate massage.

Movember: Testicular Cancer

Testicular Cancer & Self-Examination

It is November this month, which is also the month of Movember! Movember is an annual event which to most people, involves the growing of moustaches and beards. But the true meaning behind Movember is to raise awareness of men’s health issues, such as prostate cancer, testicular cancer, and men’s suicide. 

In the same vein, today we will be talking more about testicular cancer and self-examination. Testicular cancer is the most common cancer in men aged 15 to 34 years.

The testicles are the sex organs located inside the scrotum. They produce the male sex hormones and sperm for reproduction. Testicular cancer is a cancer that arises from the cells that make up the testicle. Testicular cancer is comparatively rare when put side by side with other cancers, but testicular cancer is the most common cancer in males between the ages of 15 and 35.

Signs & Symptoms Of Testicular Cancer

  • A lump or enlargement of the testicle (cancer usually affects one testicle in most cases)
  • A feeling of discomfort, pain or heaviness in the testicle or scrotum
  • A dull ache in the lower abdomen or groin
  • Fluid in the scrotum
  • Groin lymph node swellings 
  • Breast swelling or tenderness

Know Your Risk!

Are you between 15-35 years old, of certain ethnicity, have an undescended testicle or a personal or family history of testicular cancer? Consider a testicular cancer screening.

The chances of a cure and full recovery increases when the cancer is detected EARLY.


The vast majority of testicular cancers are from germ cells (the cells that produce immature sperm). They can be either a seminoma or nonseminoma tumour. What causes germ cells to become abnormal and develop into cancer isn’t known, but factors that may increase your risk of testicular cancer include:

  • An undescended testicle
  • Personal history of testicular cancer (e.g. in other testicle)
  • Abnormal testicle development
  • Syndromes such as Klinefelter syndrome
  • Family history of testicular cancer
  • Being ages 15-35, however, testicular cancer can occur at any age too

However, many men with testicular cancer have no known risk factors

Cancer can also arise from the stromal (connective) tissues. These are often benign but sometimes can be malignant. These grow in the tissues that produce hormones inside the testicles. Testicular cancers can also be secondary (spread to the testicles from other organs), or lymphomas. 

Treatment For Testicular Cancer

Testicular cancer is highly treatable as they are very sensitive to chemotherapy, even when the cancer has spread outside of the testicle. Cure rates can reach as high as 90%-95%. However, patients cured of testicular cancer have about a 2% risk of developing a cancer in the contralateral testicle. 

If testicular cancer is found early when it is small and has not spread, the chances of a cure is much higher. Early testicular cancers may cause symptoms listed above that lead men to seek medical attention. The most common presenting symptom is a lump on the testicle. Having said that, testicular cancers in other people may not cause symptoms until the later stages.

There are doctors that recommend all men examine their testicles monthly after puberty, but because testicular self-exams have not been studied enough to know if they reduce the death rates from testicular cancer, no clear guidelines exist on whether or not they should be recommended to everyone. Each man has to decide for himself if he wants to examine himself. This might be more important if you have any of the risk factors listed above. Seek medical attention immediately if you do find a lump. Your doctor will advise as appropriate.

Testicular Self-Exam (TSE)

The testicles are easiest to examine when the skin of the scrotum is relaxed. The skin is usually relaxed when you are relaxed, or after a warm shower or bath. You can examine yourself lying down or standing up. Most doctors will examine you standing up. 

  1. Hold your penis away.
  2. Hold your testicle one at a time between your thumb and fingers.
  3. Roll it gently between your fingers.
  4. Feel for any lumps, bumps or fluid.
  5. If you do examine your testicles regularly, you will eventually know what is normal for you and what is different. Feel for any change in the size, shape, or consistency of your testicles. Seek medical attention if you notice any difference.

What’s Normal?

  • One testes may be slightly larger than the other
  • One side may hang lower than the other
  • Part of the testicle is known as the epididymis where sperm is stored. This may be felt as a bump at the posterior upper or posterior middle aspect of the testicles
  • Above the testicles you may feel a cord like structure – this is the spermatic cord where sperm is carried.

What’s Abnormal?

  • An abnormally large testes compared to the other side
  • A hard lump
  • Fluid around the testicle 
  • Dilated veins above the testicles which may feel like worms 
  • Tender lumps

Not all the above abnormalities are related to cancer. But if you do find such abnormalities, please visit your doctor for a consultation. One of the easiest ways to characterize a lump is with an ultrasound, which is completely painless.

Happy Movember everyone!

Speak To Our Male Doctor Today!

If you are experiencing any symptoms, or have any concerns or questions about prostate cancer and prostate cancer screening, please make an appointment with our clinics today or visit any of our Men’s Health Clinics or drop us an email at hello@dtapclinic.com for an appointment.

Movember (Moustache + November)

Movember (Moustache + November) is a global movement by the Movember Foundation which puts the spotlight on men’s health, especially prostate cancer, testicular cancer, mental health and suicide prevention.
The Movember Foundation recognized that males of all ages may hide their pains and suffering and ultimately result in greater problems, including an untimely demise. Unlike females, males are unlikely to share their deeply personal pains and suffering with others, including loved ones or professionals. This is why it is important for fellow males to stand up for each other, and lift them up from the fog of suffering and silence.

Cancer and Suicide – Not a pretty picture

Prostate Cancer

Prostate cancer now makes up one in seven cancers in Singapore males and is the third most common cancer now. In the five years from 2011 to 2015, almost 20% of those diagnosed with prostate cancer died. What is worse is that prostate cancer in the early stages has no symptoms at all. The earlier the cancer is diagnosed, the more likely the treatment will be successful for patients and help them remain in remission.

Testicular Cancer

While testicular cancer only accounts for 1 to 2% of all cancers in males, it is the most common cancer in young males between ages 20 to 40 – at the prime of their lives. Like prostate cancer, the earlier testicular cancer is diagnosed, the more likely that a cure is achievable.
See:  How to Perform Testicular Self-Exam

Suicide Prevention

More than 70% of all suicides in Singapore for 2018 were males. This is not unique to Singapore. In Australia, males accounted for 75% of suicides. The number of male suicides in Singapore is twice that of women and the majority were aged 65 years old and above.
It is generally believed that many factors contributed to these statistics. Societal pressures for males to “Man Up” means that males may feel isolated and have nowhere to turn to for help.
In addition, many males may feel that if they seek the help they will lose status or identity and they fear that they may lose independence, competence, control, and autonomy, all of which are perceived norms expected of males.

Mental Health

Finally, a previous study by Oogachaga (a non-profit community-based organisation that works with LGBTQ individuals) in Singapore showed that 3 in 5 LGBT individuals who participated in the survey reported facing some form of discrimination as a result of their sexual orientation. This may be part of the reason why in 2015 a study in CDC found gay and bisexual youths in the U.S. are 4 times more likely to have attempted suicide than their straight peers.

What can you do?

Now, anyone, especially males, can step forward and support your buddies and families by:

  1. Growing a moustache or beard for the month of November.
  2. Pledge to walk 60 km for the month of November – for the 60 men that are lost every hour globally due to suicides.
  3. Spend time with your buddies – be it having a night out or playing a favourite sport or whatever activity you enjoy doing together.

For the whole month of November, Dr. Tan & Partners (DTAP) is proud to support the Movember 2019 initiative with a supportive and friendly environment throughout all its clinics for men of all ages to seek help for all men’s health issues.
Dr. Julian Ng

Dr Julian Ng has 10 years of medical practice experience. He currently serves as the Chief Medical Officer of the DTAP Group of clinics in Singapore and Malaysia. He is also a member of the Singapore Men’s Health Society. His special interests are in the field Andrology, especially sexual health. He is currently practising at Dr Tan and Partners (DTAP) clinic at Novena Medical Centre.