Sir, Have You Checked Your Prostate?

December 28, 2022
Prostate cancer is the fifth most common cancer among men in Malaysia. It can happen to men as ‘young’ as 40, and as elderly as 75.  

The risk of prostate cancer increases with age as cancer develops very slowly over time. In fact, more than 60 percent of cases are discovered at Stage 3 and 4.  

However, did you know that if detected early, prostate cancer has the highest survival rate compared to other cancers?  

Since November is Men’s Health Awareness Month, perhaps it is an ideal time to start monitoring your prostate health.  

Firstly - the prostate
The prostate is a small muscular gland in the male human body, located below the bladder. Its main function is to produce seminal fluid that nourishes sperm.  

A young man’s prostate is the size of a walnut. As a man ages, the prostate grows and can become as big as a ping-pong ball, or even an orange. Sometimes, this growth may trigger cancer cells resulting in prostate cancer.  

“To this day, the cause of prostate cancer is still a mystery,” says Consultant Medical Oncologist, Dr Kananathan Ratnavelu who is based at the newly launched Columbia Asia Cancer Center at Columbia Asia Hospital – Bukit Rimau, Selangor.  

“But certain risk factors have been noted down such as advancing age, family history of cancer, genetic risks, diet and lifestyle.”  

Warning signs of prostate cancer
“Some common symptoms of prostate cancer include an increased frequency to urinate especially at night, weak or intermittent urinary flow, trouble withholding urine, trouble urinating, a sensation that the bladder is not completely empty even after urinating, dull pain in the groin and blood in the urine,” says Dr Kanan. “In fact, in advanced stages of prostate cancer, back pain and bone pain can also be symptoms.”  

Finding out is a process
  • Prostate Specific Antigen test (PSA)
    • There is a type of protein made only in the prostate gland called the prostate specific antigen (PSA). A basic blood test can show levels of PSA in the body. High levels may mean high chances of prostate cancer; hence the patient will need to be evaluated further.
  • Digital Rectal Examination (DGE)
    • Another way to detect prostate cancer is via a digital rectal examination (DRE). This is carried out by a trained medical professional.
    • “A DRE is actually a quick and simple test, but because the procedure itself is invasive, it comes across as daunting and somewhat uncomfortable,” says Dr Kanan.  
    • According to him, the patient will be more accepting of a DRE if he is well-informed of the exact location of the prostate. In this case, the prostate is positioned right in front of the rectum. By inserting a finger into the rectum directly, the doctor will be able to feel the prostate for suspicious lumps.  
  • Prostate Biopsy
    • “Whenever a cancer screening shows that further tests are needed, the gold standard of a follow-up is a prostate biopsy,” shares Dr Kanan.
    • A prostate biopsy is a procedure where a needle is used to collect tissue samples from the prostate. These samples are analyzed closely to determine if they are cancerous or not.  

To know or not to know?
“Definitely to know,” exclaimed Dr Kanan. “I cannot over emphasize the urgency of screening for prostate cancer, especially if you are over 50. Knowing early can save your life.”  

To find out more about prostate screenings and other cancer care services of Columbia Asia Cancer Center at Columbia Asia Hospital – Bukit Rimau, visit

Dr. Kananathan A/L Ratnavelu
Consultant Medical Oncologist
Columbia Asia Hospital – Bukit Rimau

MBBS (UM), FRCP (Ireland), AM (Malaysia)
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  This article first appeared in Malaysiakini, 1 November 2022.
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