Prostate Cancer Malaysia: Myths, Facts & Early Detection

Debunking Myths and Highlighting the Importance of Early Detection in Malaysian Prostate Cancer Cases

Despite being the third most common cancer affecting men in Malaysia, prostate cancer remains shrouded in misunderstanding, leading to late diagnoses and poorer outcomes. According to the Malaysian National Cancer Registry Report (2017–2021), nearly three out of four cases are diagnosed at an advanced stage, a trend that continues to worry medical professionals.

The Silent Threat: Why Early Detection Matters

A significant number of Malaysian men present with advanced-stage prostate cancer, where the disease has already spread to the bones and symptoms are severe, according to a consultant in clinical oncology from Icon Oncology. This delay in diagnosis is often fueled by pervasive misconceptions about the disease. Addressing these myths is crucial to improving survival rates and quality of life for men across the country.

Myth 1: Prostate Cancer is an “Old Man’s Disease”

One of the most damaging beliefs is that prostate cancer only affects older men. While the risk dramatically increases after age 60 – with 85% of cases diagnosed in men 60 and above – a concerning 15% are found in men under 60. This misconception leads many men to forgo screening in their 40s and 50s, allowing the disease to progress undetected.

The early stages of prostate cancer are often asymptomatic. Symptoms like difficulty urinating, a weak stream, or urine leakage are frequently dismissed as normal signs of aging. More serious warning signs, such as persistent back pain, pelvic discomfort, or unexplained weight loss, typically appear only after the cancer has metastasized, making treatment more complex and reducing survival chances.

Myth 2: Prostate Cancer Doesn’t Affect Asian Men

A dangerous and inaccurate belief persists among many Malaysian men that prostate cancer is primarily a “Western man’s cancer,” assuming Asians are less susceptible. This is demonstrably false. As one expert stated, “It’s a global cancer.” The higher incidence rates observed in Western countries are largely attributed to more robust screening programs and advocacy efforts, not inherent biological differences.

In Malaysia, a lack of routine screening and an underestimation of personal risk contribute to men seeking medical attention only when symptoms become debilitating.

Myth 3: A High PSA Reading Automatically Means Cancer

Misunderstandings surrounding the prostate-specific antigen (PSA) test are also common. While PSA testing is a vital tool for early detection, an elevated reading does not automatically indicate cancer. It could be caused by benign prostate enlargement or inflammation.

However, many men experience undue panic upon receiving a high PSA result, while others avoid testing altogether out of fear. The correct course of action, according to medical professionals, is to seek a thorough evaluation by a urologist to determine if further investigation is necessary. Despite the prevalence of these misconceptions and anxieties, early detection remains the most powerful factor in improving outcomes, with many men living well over a decade after treatment with timely diagnosis.

Understanding Diagnosis and Treatment Options

Beyond the PSA test and digital rectal examination, doctors utilize advanced diagnostic tools like multiparametric MRI, PSMA PET scans, and biopsies to confirm the presence and aggressiveness of prostate cancer. Treatment strategies are highly individualized, depending on the stage of the cancer.

For men diagnosed at an early stage, a “watchful waiting” approach – known as active surveillance – may be employed. This involves close monitoring with regular tests and scans, avoiding unnecessary treatment while ensuring any progression is promptly detected. When treatment is required for cancer confined to the prostate, options include robotic prostatectomy (prostate removal) or radiotherapy, delivered externally or through internal radioactive sources. Hormone therapy may be added to radiotherapy for more aggressive cases to enhance effectiveness.

Advanced prostate cancer treatment options include hormone therapy, chemotherapy, and radiotherapy, tailored to each patient’s specific needs and cancer characteristics. Significant advancements have been made in recent years, with highly effective oral and intravenous treatments now available to extend life expectancy even in cases of widespread cancer.

The Importance of a Holistic, Multidisciplinary Approach

Effective prostate cancer management extends beyond medication and technology. A holistic approach, encompassing screening, diagnostics, treatment, and psychosocial support, is essential. As one oncologist emphasized, “I believe in a holistic and end-to-end approach in cancer care.” This requires a collaborative team of urologists, oncologists, radiologists, nuclear medicine physicians, pathologists, and cancer support professionals, each playing a vital role in delivering the best possible care.

Prioritizing Early Screening and Taking Charge of Your Health

Specialists recommend that men begin prostate cancer screening around age 50, or even earlier at age 40 if they have a family history of the disease or other risk factors. Overcoming barriers like fear, embarrassment, and misinformation is crucial. Today’s diagnostic tools and treatments are highly effective, offering many men the chance to overcome the disease and maintain a good quality of life.

“Do not ignore symptoms, no matter how small. Don’t assume you’re too young and don’t be afraid to get your PSA checked,” urges one expert. “If your PSA is raised, don’t panic. See a doctor and get evaluated properly. In the end, it comes down to taking charge of your health. We want to detect cancer early so we can treat it effectively. Give yourself the best chance.”