More than 70% of cancer of the prostate, a male gland located below the urinary bladder and in front of the rectum, is diagnosed in men who are 65 or older. Prostate cancer usually grows more slowly than other cancers, taking as many as 10 to 30 years before tumors get large enough for doctors to diagnose them or for the symptoms to show up. More than half of men who reach 80 years old have some cancer in their prostate.
Symptoms
Urinating frequently, especially at night,
Difficulty holding back urine
Slow start, weak or interrupted flow of urine
Pain or burning sensation when urinating
Difficulty having or sustaining an erection
Painful ejaculation
Blood in urine or semen
Frequent pain or stiffness in lower back, hips, or upper thighs
Patients with prostate cancer will normally have to undergo a prostatectomy, which is a surgical procedure to remove the tumor. The emergence of new surgical instruments means that in most cases, this will involve minimally invasive surgery, which in turn means shorter hospital stays, less discomfort and bleeding, and faster recovery.
Another option is brachytherapy, which is radiation therapy delivered from a short distance. Doctors place radioactive seeds or sources in or near the tumor and increase the radiation dose to the tumor while minimizing radiation exposure to healthy tissues nearby.
Pancreas cancer
Cancer of the pancreas can be difficult to diagnose, as the pancreas lies behind other organs, including the stomach, gallbladder, liver, and spleen.
Symptoms
Nausea
Loss of appetite
Weight loss for no apparent reason
Pain in the upper or middle abdomen
Jaundice (yellowing of the skin)
Pancreatic cancer is very difficult to treat, as it is usually discovered late. Symptoms often do not emerge early, and screening tools tend not to be effective. Depending on how advanced the cancer is and whether it has spread beyond the pancreas, options for treatment include surgery, radiation therapy, or chemotherapy.
Bladder cancer
Cancer of the bladder, which holds urine, usually hits those older than 40 and mostly those between 50 and 70 years old. Men are five times more likely to be hit by bladder cancer than women in Singapore.
Symptoms
Blood or blood clots in urine
Difficulty passing urine
Pain during urination
Pain in the lower back
Treatment usually consists of one of the three standard treatments: surgery, radiation therapy, chemotherapy, or combinations. New forms of treatment have also emerged, including one called photodynamic therapy, which combines special drugs and light therapy to kill cancer cells. Doctors inject a drug that makes cancer cells more sensitive to light into a patient’s bladder rather than train a special light on the bladder, which targets the cancer cells and kills them.
Lymphoma
Non-Hodgkin’s lymphoma can strike both young and old people, but occurrences increase with age. Most patients with this cancer are over 60 years old. Cancer starts in a person’s lymphatic system, which is part of the immune system that fights infection and disease.
Symptoms
Swollen, painless lymph nodes in neck, armpits, or groin
Constant fatigue
Unexplained weight loss
Sweating at night
Coughing and breathing problems
Chest pains
Swelling or feeling of fullness in the abdomen
Treatment for lymphoma usually revolves around chemotherapy. Drugs are either injected intravenously or given in pill form. Doctors may also combine targeted chemotherapy with standard cytotoxic chemotherapy, which has given encouraging results. Doctors may also prescribe bone marrow transplants when lymphoma patients have a relapse or are struck by aggressive lymphomas.
Not all patients, however, will be suitable for this combination of a transplant with chemotherapy, as high-dose chemotherapy drugs can also kill healthy bone marrow. New drugs have also emerged, along with a better supportive treatment that allows doctors to administer chemotherapy at shorter intervals to achieve better results.
Liver Cancer
There are two types of liver cancer: primary liver cancer, or hepatocellular carcinoma, which begins in the liver; and secondary liver cancer, which is the result of cancer spreading from other cancerous organs or sites. Men are much more likely to get primary liver cancer, especially if they are older than 40. Liver cancer is closely linked to chronic Hepatitis B infection, which can lead to cirrhosis, scarring of the liver, liver failure, and liver cancer. People usually acquire the Hepatitis B virus during birth or in early childhood; one in 35 adult Singaporeans is a carrier of the virus.
The hepatitis B virus can be transmitted through blood or bodily fluids. As it may not show any noticeable symptoms, hepatitis B and liver cancer patients are often diagnosed only when they donate blood or undergo health screening. Hepatitis B, however, can be prevented through vaccination. The hepatitis B vaccine, which is administered in three doses, is 95 percent effective in preventing children and adults from getting chronic hepatitis B infections.
Only early liver cancer can be cured, mainly through surgery, which enables up to 80 percent of the affected liver to be removed. Patients, however, can take assurance from the fact that the liver can re-grow—in fact, it is the only organ in the body that does this—even after half of it has been removed. If surgery cannot remove advanced liver cancer, doctors may prescribe chemotherapy, usually chemoembolization, which targets the area with cancer. Some patients with advanced liver cancer may not be suitable for surgery or chemotherapy, but they can take heart:
There are more options. They include percutaneous ethanol injection, in which ethanol is injected through the skin directly into the liver. The alcohol dries out the tissues and stops the blood supply to cancer, thus killing it. This is effective for patients who have few or small tumors measuring less than 3 to 4 cm. Another option is radiofrequency ablation, which uses heat to destroy the cancer cells. Radio waves from a laser beam are directed through a needle inserted into cancer cells, destroying them in the process.
Treatment of Prostate Cancer
What is good care for prostate cancer? For many men with prostate cancer, no treatment will be necessary. Good care will mean keeping an eye on cancer and ensuring that it does not develop into a fast-growing cancer. When treatment is necessary, the aim is to cure or control the disease so that it does not shorten life expectancy and affects everyday life as little as possible. Sometimes, if cancer has already spread, the aim is not to cure it but to prolong life and delay symptoms. People with cancer should be cared for by a multidisciplinary team (MDT).
This is a team of specialists who work together to provide the best treatment and care. The team often consists of a specialist cancer surgeon, an oncologist (a radiotherapy and chemotherapy specialist), a radiologist, a pathologist, a radiographer, and a specialist nurse. Other members may include a physiotherapist, dietitian, or occupational therapist. You may also have access to clinical psychology support. When deciding what treatment is best for you, your doctors will consider:
The type and size of the cancer
You’re general health
Whether cancer has spread to other parts of your body
What grade it is good to care for prostate cancer includes giving information to men and their partners or caregivers about the treatment of prostate cancer and its effects on:
Sex life
Physical appearance
Ability to control urination and bowel movement
Other physical and psychological aspects of masculinity that might be affected by sex hormone treatment
You’re MDT will be able to recommend what they feel are the best treatment options, but ultimately the decision is yours.
In 2008, the National Institute for Health and Clinical Excellence (NICE) made recommendations about treatments that are offered to men with the three main stages of prostate cancer: localized prostate cancer that is just in the prostate gland and locally advanced prostate cancer that has spread beyond the prostate capsule.
But it is still connected to the prostate gland, relapsed cancer that has returned after treatment, and metastatic prostate cancer (cancer that has spread outside the prostate gland with no remaining link to the original cancer in the prostate gland). Different types of cancer tend to hit different categories of people. Knowing the risks and recognizing the signs could be critical.
This is the fourth of a four-part series looking at common cancers that hit women, men, children, and the elderly. Older people face a higher risk of cancer. About 77 percent of all cancers that are diagnosed are found in those who are 55 years and older. If you are 65 or older, the chances of getting cancer are 10 times higher than if you are under 65.
Cancer patients over the age of 65 are also 15 times more likely to die from the disease. This is because longer exposure to environmental and dietary factors produces a cumulative effect on the body. Older people are also less able to repair cellular damage, which can result in cancer if not removed.
