Treating Prostate Cancer In Singapore With Brachytherapy

Medically reviewed by Dr Johann Tang, Senior Consultant Radiation Oncologist
Radiation Machine for Prostate Cancer

As the 3rd most common cancer diagnosed in males in Singapore, prostate cancer has been increasing in incidence over the last few decades. Read on to learn more about the symptoms and risk factors of prostate cancer, as well as various types of radiation treatment for  prostate cancer radiation treatment such as proton, IGRT, and brachytherapy

What is prostate cancer?

Prostate cancer is cancer of the prostate gland, which is located below the bladder near the urethra in males. Some of the symptoms of prostate cancer include frequent urination at night or an inability to urinate, pain or a burning sensation when urinating, blood in the urine, bone pain, as well as unexplained weight loss and loss of appetite. The risk of prostate cancer increases in men who are over the age of 50, as well as in those who are obese, eat a diet high in fat, and have a family history of prostate cancer. 


How is prostate cancer diagnosed?

Early detection is crucial for effective prostate cancer treatment. Screening tests can help detect prostate cancer early.

  • Digital Rectal Exam (DRE)

During a DRE, a doctor will insert a gloved, lubricated finger into the patient’s rectum to inspect the prostate and check for any irregularities.

  • PSA Blood Test

The prostate gland produces a substance known as prostate-specific antigen (PSA), which can also be found in the bloodstream. Elevated levels of PSA in the blood may indicate the possibility of prostate cancer.

  • Ultrasound

A small probe will be inserted into the patient’s rectum to create images of the prostate gland using sound waves. It is used to guide a biopsy of the prostate.

  • Biopsy

This procedure involves removing sample tissues from the prostate gland for analysis to determine the presence and aggressiveness of cancer cells. If the result is positive for cancer, imaging such as Magnetic Resonance Imaging (MRI) and/or Computed Tomography (CT) scanning of the pelvis may be required to ascertain the extent of the cancer.


Symptoms of prostate cancer

Symptoms of prostate cancer include:

  • Frequent urination at night
  • Inability to urinate
  • Weak or interrupted flow of urine
  • Pain or a burning sensation when urinating
  • Blood in the urine or semen
  • Pain in the back, chest (rib), hips, pelvis, or other bony areas
  • Unexplained weight loss and loss of appetite
  • Painful ejaculation
  • Erectile dysfunction

The good news about prostate cancer is that it is often diagnosed at early stages with timely screening, making the long-term prognosis for the average patient highly encouraging as compared to other forms of cancer. Radiation oncologists are able to provide effective radiation treatment for prostate cancer, greatly increasing the likelihood of a full recovery. To reduce the risk of prostate cancer, it helps to eat a healthy diet incorporating fruits and vegetables, exercise regularly, and maintain a healthy weight.


When should you seek a doctor?

However, it should be noted that prostate cancer cells usually grow slowly compared to other forms of cancer. It can take up to 30 years before a tumour gets sufficiently large to cause symptoms. By the time these symptoms surface, the cancer may already be advanced. 

With that said, some precancerous or cancer cells may already be present at an early stage. Therefore, it is vital to undergo test screenings regularly and understand and spot the symptoms early. This way, patients can seek appropriate prostate cancer treatments promptly. If you have experienced any of the symptoms of prostate cancer shared above, please consult a doctor immediately.


What are the available treatments for prostate cancer?

Generally, radiation treatment is the main modality used to treat prostate cancer, delivering radiation that damages the DNA of cancer cells and stops their further growth. Your doctor may recommend External Beam Radiation Therapy (EBRT) to precisely target and eradicate cancer cells in the prostate gland from outside the body while minimising damage to the surrounding healthy tissue. Brachytherapy is another form of radiotherapy your doctor may recommend to deliver radiation to the prostate.

Other prostate cancer treatment methods include surgery for localised tumours at the earlier stages of prostate cancer and hormone therapy, which interferes with the growthstimulatory effects of male hormones. Hormone therapy, in particular, is often used in conjunction with other prostate cancer treatment modalities to enhance the effectiveness of primary treatment and control the growth and spread of cancer cells. For more advanced stages of prostate cancer, hormone therapy is synergistic with radiotherapy, lowering the chance of recurrence.


What radiation treatments are used for prostate cancer?

Brachytherapy is one of the most commonly utilised radiation treatments for prostate cancer. It is a form of internal radiation therapy that involves the insertion of a radioactive source close to or inside the tumour, allowing it to deliver radiation effectively to the targeted area while minimising radiation exposure to healthy tissue. Brachytherapy treatment courses in Singapore tend to be completed in a shorter period compared to other radiation therapy techniques, reducing opportunities for cancer cells to grow and divide in between doses while allowing patients to make fewer visits for a more accessible and convenient treatment experience. 

Brachytherapy in Singapore is administered either via permanent radioactive seed implants in the case of Low Dose Rate (LDR) treatments, or by moving a radioactive source temporarily during a session for High Dose Rate (HDR) treatment. LDR and HDR differ in terms of the duration that the radioactive sources are placed in proximity to the cancer, which influences the total dosage of radiation received during each treatment session. HDR radiation treatment for prostate cancer offers more precise targeting and stronger treatment while also removing the risk that can arise with seed implants moving away from their intended positions due to swelling.

Other forms of radiation treatment for prostate cancer include external beam radiation therapies, such as Image Guided Radiation Therapy (IGRT) which uses advanced imaging equipment to facilitate the precise targeting of cancer tumours to minimise damage to healthy tissue. Another option is proton therapy, which utilises positively charged protons that deliver effective focusing of their energy to target tumours while minimising damage to nearby tissue as they enter the body, reducing side effects, and improving patients’ recovery.

Seeking quality prostate cancer radiation treatment in Singapore? Get in touch with us today to arrange for an appointment and consultation.

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Dr Johann Tang

Senior Consultant Radiation Oncologist
Medical Director of ME Novena Specialist Group Pte Ltd
MBBS (Aust), FRANZCR (Radiation Oncology)

Dr Johann Tang is the Senior Consultant and Medical Director of ME Novena Specialist Group Pte Ltd. at Mount Elizabeth Novena Hospital and an Assistant Professor at the Yong Loo Lin School of Medicine, National University Singapore.  Dr Tang’s journey towards being a radiation oncologist in Singapore started with him obtaining his medical degree from the University of Newcastle, Australia, in 1998 and completing his house officer training at the Hunter Area Health Service before returning to Singapore to complete his National Service in the Singapore Armed Forces Medical Corps. Thereafter, he did his specialty training in Radiation Oncology in Singapore at the National University Hospital (NUH). After obtaining his fellowship from the Royal Australian College of Radiologists (FRANZCR) in 2007, Dr Tang underwent breast brachytherapy fellowships at the University of Wisconsin as well as prostate brachytherapy, skin, and paediatric fellowships at the Peter Maccallum Cancer Institute, Australia. In 2021, Dr Tang underwent a fellowship at the New York Proton Centre with Dr Charles Simone in head and neck, re-irradiation, paediatric, prostate, and lung cancers.

Why Choose Dr Johann Tang

Dr Johann Tang is an experienced radiation oncologist and cancer doctor who aims to deliver the highest level of care to his patients, especially when it comes to radiation therapy and cancer treatment. As a cancer specialist in Singapore, he is dedicated to understanding each patient’s condition and providing holistic, customised care that is both effective and compassionate. With ethics and empathy at the core of our practice, we strive to understand your individual needs and provide care that is compassionate and responsive.

Experienced Radiation Oncologist

Dr Johann Tang is a highly experienced radiation oncologist and cancer specialist in Singapore, with over 20 years of experience treating various cancers in both adults and children and several accolades to his name. Prior to entering private practice, where he is currently a senior consultant and medical director. Dr Tang was at NUH for 18 years, from 2001 to 2019. Dr Tang spearheaded and built up the breast brachytherapy (Accelerated Partial Breast Irradiation APBI), outpatient interstitial image-guided cervical brachytherapy, and paediatric radiation therapy services at NUH to provide an array of the latest and best cancer treatment options for patients. As a cancer doctor, Dr Tang is also passionately involved in research, having authored numerous peer-reviewed publications and won several research prizes.

Evidence-based Treatments

Dr Johann Tang and his team utilise technology that has proven to be effective in cancer treatment. Having decades of experience in treating and researching the disease has enabled Dr Tang to remain current and on top of best practices and novel techniques, providing his patients with full assurance that they are receiving the most effective treatment available.

Patient-centered Care

Dr Johann Tang’s patients are his top priority. He journeys with them from diagnosis until the completion of treatment. With Dr Tang, all patients can be fully assured that their clinical needs and well-being are attended to. Dr Tang is also passionately involved in research, having authored numerous peer-reviewed publications and winning several research prizes.

"I guarantee my very best expertise delivered with compassion and dignity as we journey TOGETHER to BEAT this dreaded illness."

- Dr Johann Tang

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