Motorcycle riders wearing tailored suits participate in the 10th Distinguished Gentlemen's Ride along Macapagal Avenue in Parañaque City on May 23, 2021. Around 60,000 classic and vintage style motorcycle riders across the world are expected to join the annual ride, which first started in Sydney, Australia, in a bid to raise funds and awareness for prostate cancer research and men's mental health.

Prostate cancer is an emerging global health concern — it is the fifth most commonly-diagnosed cancer and the third most commonly-diagnosed cancer in men — and has seen rising mortality rates, particularly in Asia.

While screening is an integral part of the comprehensive management of this disease, it is not meant for all men.  

Screening is a shared decision made for patients identified at risk. 

The most significant risk factors is family history, which may increase the risk of developing the disease by 50% in men with brothers or fathers diagnosed with prostate cancer. 

Other risk factors are age, obesity, and ethnicity.

COMMON SYMPTOMS 

Men will most commonly consult with a myriad of symptoms related to urination such as urinary retention, frequency, urgency, incontinence and nocturia —constant urination at night — which are most often related to enlargement of the prostate gland.  

Screening for prostate cancer entails a digital rectal examination performed by a urologist or any licensed physician and a prostate specific antigen (PSA) blood test. 

Screening should always be a shared decision between physician and patient and is usually reserved for men with presenting symptoms who also have risk factors that starti at 50 years of age. 

It is important to note that positive findings on screening — for example, prostate enlargement, palpable prostatic nodules, an elevated PSA or both — does not automatically mean a diagnosis of prostate cancer. 

The best way to establish the diagnosis is with a prostate biopsy, which is a needle biopsy done under ultrasound guidance.

TREATMENT

Treatment, like with most other cancers, will depend on the stage of the disease.  

For localized disease where the cancer is confined to the prostate gland, surgery and radiation therapy have excellent outcomes. 

Active surveillance, which entails regular PSA monitoring and annual prostate biopsies is suitable in well selected patients. 

For locally advanced disease, where the cancer has spread just beyond the prostate, a combination of treatment modalities would provide the best outcomes. 

Surgery or radiation therapy in combination with androgen deprivation therapy (medical or surgical castration) are most frequently used with excellent outcomes. 

EXCELLENT SURVIVAL RATES

Metastatic disease, where the cancer has spread to distant organs, often signifies the end of the road for other cancers. 

Prostate cancer, however, has shown good survival outcomes even in patients with metastatic disease. 

Treatment is most often a combination of androgen deprivation therapy and novel hormonal therapy or chemotherapy with survival rates surpassing five years in most patients.

Survival rates are excellent for prostate cancer. 

The five-year Relative Survival rate is 97.1%, 10-year Relative survival is 98% and 15-year relative survival is 95%.   

Breaking it down to individual disease states, patients with localized and locally advanced prostate cancer are expected to have five-year relative survival rates of 100%, metastatic disease five-year survival drops to 34.1% and for those with unknown disease stage, the expected 5-year survival is 91.5%.

With early diagnosis and treatment from properly screened patients, prostate cancer can be cured and most men diagnosed will die with this disease rather than from it.

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Established in September 1936, the Philippine College of Surgeons is the country's premier organization of surgical professionals. PCS has several surgical specialty societies including the Philippine Urological Association.