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EP249: Ending late stage prostate cancer | PUTTING DR G ON THE SPOT
The Star
Follow
11/23/2024
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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Category
🛠️
Lifestyle
Transcript
Display full video transcript
00:00
So the last section we're doing is the last stage of prostate cancer.
00:06
Sadly, in Malaysia, about two-thirds of men presented with stage 3 prostate cancer,
00:12
meaning that the cancer has already spread to the lymph node
00:16
or has spread to other organs, primarily the bones.
00:20
What seems to be the problem?
00:28
It's because patients presented late.
00:31
And that's the reason why they actually get into such trouble.
00:35
So if the patients actually started getting regular check-ups such as PSA blood tests,
00:41
then something like that will change quite dramatically,
00:44
like in high-resource countries such as USA and UK,
00:49
where only one-third of the patients probably presented with prostate cancer at late stages.
00:56
Let's talk about treatment itself.
00:59
So when people start thinking about late-stage cancer, they think about death.
01:04
However, prostate cancer is quite peculiar,
01:07
in the sense that it is controlled by hormone,
01:11
and when men are deprived of testosterone, then the cancer stays dormant for a long time.
01:18
What it means is that even if you are presented with late-stage prostate cancer,
01:23
you do not go into a doom period of short-term life expectancy and subsequently death,
01:32
and a lot of prostate cancer can be controlled by hormonal suppression.
01:37
So the hormonal suppression can be done several ways.
01:40
The old way of doing it is castration,
01:43
meaning that we remove both testicles to deprive the men of testosterone.
01:48
Other newer method is injecting a type of medicine called LHRH agonist.
01:56
LHRH is a hormone produced by the brain.
02:00
If you inject this agonist, then it will trick the brain to suppress the production of such hormone,
02:07
as a result and shrinkage and the reductions of the production of testosterone from the testicle.
02:14
Apart from that, other way of doing it is to take medicine which is an anti-androgen,
02:20
and then this medicine can suppress it.
02:23
Although it sounds quite cruel that you castrate a man or medically castrate a man,
02:29
the reality is that men will experience the same problem as women when they undergo menopause.
02:36
So the hot flushes, night sweating will all emerge just like how it happens in a woman.
02:42
So it's not too dramatic.
02:44
However, things to take into account will be osteoporosis,
02:48
because without the testosterone, a man's bone become quite brittle,
02:52
and therefore we need to protect the bone strength.
02:55
For men who subsequently develop castration-resistant prostate cancer,
03:01
then there are several drugs that are available to control it,
03:04
but the end stages of cancer itself can be quite horrible
03:08
in the sense that it will cause a man to be anemic, fracture bone,
03:13
constipation because of enlarged prostate causing obstruction of the bowel,
03:17
and also retention of urine.
03:20
So obviously to avoid all these, the way is to get screened,
03:24
and to avoid late stage prostate cancer, and to avoid castration altogether.
03:30
So for the month of December, I think we're going to make it a bit light-hearted.
03:34
We're going to deal with myth of cancer and also other men's health subjects.
03:39
The first one that we're going to deal with is vasectomy associated with prostate cancer.
03:45
If you're concerned about such myth, and you're interested to find out,
03:49
stay tuned for next week's Putting Dr. G on the Spot.
04:00
For more information visit www.FEMA.gov
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