Prostate Cancer: The Silent Threat Men Aged 45+ Should Know

Prostate cancer is one of the key health concerns affecting men as they age. Because early-stage disease may develop without noticeable symptoms, health authorities are encouraging men particularly those aged 45 and above or with additional risk factors to understand the warning signs, consider appropriate screening, and become aware of advances in diagnosis and treatment that may help preserve quality of life.

The prostate is a male reproductive organ located below the bladder and surrounding the upper portion of the urethra. It contributes fluid that forms part of semen and supports reproductive function. While the prostate commonly enlarges with age, abnormal and uncontrolled growth of prostate cells can develop into prostate cancer.

As cancerous cells grow, they may compress the urethra and interfere with normal urination. In more advanced cases, cancer may spread beyond the prostate to other parts of the body, potentially damaging vital organs and becoming life-threatening.

Early Prostate Cancer May Have No Warning Signs

One of the major challenges of prostate cancer is that the disease may cause no symptoms during its early stages. Some cases are first identified during routine health examinations or following a blood test showing an elevated Prostate-Specific Antigen (PSA) level.

As the disease progresses and the prostate begins to affect the urethra, possible symptoms may include difficulty urinating, a weak urinary stream, urinary incontinence, pain or a burning sensation during urination, and blood in the urine or semen.

These symptoms can also occur with other prostate conditions, including benign prostatic enlargement. Men experiencing such symptoms should therefore seek medical assessment rather than assuming that they are caused by cancer.

When prostate cancer reaches a more advanced stage, symptoms may include persistent back or hip pain, unexplained bone fractures, unintended weight loss, swelling of the legs, or jaundice.

Risk Increases With Age and Family History

According to information from Thailand’s health authorities, prostate cancer is more commonly diagnosed among older men, with the risk increasing particularly after the age of 50.

Family history is another important consideration. Men whose father, brother or other close male relatives have had prostate cancer may face an increased risk of developing the disease.

Several lifestyle and health-related factors have also been associated with prostate cancer risk, including excessive calcium intake, frequent consumption of heavily charred meat or saturated animal fats, being overweight, smoking and alcohol consumption. Other factors that have been studied in relation to prostate cancer include androgen hormone use, chronic inflammation of the prostate and certain sexually transmitted infections.

Understanding individual risk factors can help men make informed decisions about when to discuss prostate health and screening with a healthcare professional.

PSA Testing and Prostate Examination Support Early Detection

Prostate cancer screening may involve a combination of a Prostate-Specific Antigen (PSA) blood test and a Digital Rectal Examination (DRE).

In Thailand, screening may be considered for men aged approximately 45–75 years, particularly those with relevant risk factors or symptoms.

An elevated PSA level does not automatically mean that a person has prostate cancer. PSA levels can also be affected by other prostate conditions. However, an abnormal result or a suspicious finding during a prostate examination may lead physicians to recommend further investigation.

Traditionally, diagnosis may involve a Transrectal Ultrasound-Guided Prostate Biopsy (TRUS biopsy), in which tissue samples are collected from the prostate and examined for cancer cells.

MRI Is Changing How Prostate Cancer Is Diagnosed

Advances in medical imaging are providing physicians with more precise tools for investigating suspected prostate cancer.

One increasingly important technique is Multiparametric Magnetic Resonance Imaging of the Prostate (mpMRI). The technology allows physicians to examine the prostate in greater detail and identify areas that may require further investigation.

When a suspicious lesion is detected, MRI images can be incorporated into an MRI Fusion-Targeted Prostate Biopsy, enabling physicians to target specific areas rather than relying solely on random tissue sampling.

This approach may help reduce unnecessary biopsies in some low-risk patients, decrease the number of tissue samples required and improve the detection of clinically significant prostate cancer.

Treatment Is Becoming More Personalized

Treatment for prostate cancer depends on several factors, including the stage of the disease, aggressiveness of the cancer, age of the patient and overall health condition.

For some patients with low-risk disease, particularly when the cancer is unlikely to progress rapidly, physicians may recommend active surveillance, involving regular monitoring rather than immediate treatment.

Other treatment options may include Radical Prostatectomy, androgen-deprivation therapy, radiation therapy, brachytherapy, chemotherapy, orchiectomy and immunotherapy. The appropriate treatment strategy varies according to each patient’s clinical condition.

Surgery remains an important treatment option for localized prostate cancer. Common surgical approaches include Laparoscopic Radical Prostatectomy and Robotic-Assisted Laparoscopic Radical Prostatectomy.

Robotic-assisted surgery allows surgeons to perform highly precise movements using robotic instruments. In appropriately selected patients, this precision can support nerve-sparing techniques designed to preserve the nerves involved in erectile function while also potentially reducing blood loss and supporting postoperative recovery.

Focal Therapy May Help Preserve Sexual and Urinary Function

Advances in prostate cancer treatment are also creating options that focus on destroying cancerous tissue while preserving as much healthy prostate tissue as possible.

Known as Focal Therapy, this approach may be considered for selected patients with localized prostate cancer.

Rather than removing or treating the entire prostate, focal therapy targets the identified cancerous area. For suitable patients, this approach may help reduce some of the potential effects associated with major prostate surgery, particularly urinary incontinence and sexual dysfunction.

Several technologies can be used for focal treatment, including Irreversible Electroporation (IRE or NanoKnife), Cryotherapy, which destroys targeted tissue using extreme cold, and High-Intensity Focused Ultrasound (HIFU), which uses concentrated ultrasound energy to target abnormal tissue.

However, focal therapy is not suitable for every prostate cancer patient. Treatment decisions require assessment of the location, stage and characteristics of the cancer, together with the patient's overall condition and individual treatment goals.

Early Detection Can Improve Treatment Opportunities

Greater awareness of prostate cancer and wider use of PSA testing among men with risk factors or suspicious symptoms are helping identify more cases at earlier stages.

Early detection can provide patients and physicians with a broader range of treatment options and may significantly improve the possibility of successful treatment when the cancer remains localized.

Men are also encouraged to maintain good overall health through regular physical activity, maintaining a healthy weight, avoiding smoking, limiting alcohol consumption and reducing the intake of fatty or heavily charred meats.

For men aged 45 and above particularly those with a family history of prostate cancer discussing individual risk factors and appropriate screening with a healthcare professional can be an important part of preventive healthcare.

For further information about prostate cancer, screening and treatment, the public can consult the National Cancer Institute of Thailand and other official healthcare authorities.

 

Source :  Department of Medical Services