EP249: Ending late stage prostate cancer | PUTTING DR G ON THE SPOT - video Dailymotion

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1 year ago

Consultant urologist Dr George Lee Eng Geap, or a.k.a Dr G, delves into the treatments available for late stage prostate cancer.

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00:00So the last section we're doing is the last stage of prostate cancer.

00:06Sadly, in Malaysia, about two-thirds of men presented with stage 3 prostate cancer,

00:12meaning that the cancer has already spread to the lymph node

00:16or has spread to other organs, primarily the bones.

00:20What seems to be the problem?

00:28It's because patients presented late.

00:31And that's the reason why they actually get into such trouble.

00:35So if the patients actually started getting regular check-ups such as PSA blood tests,

00:41then something like that will change quite dramatically,

00:44like in high-resource countries such as USA and UK,

00:49where only one-third of the patients probably presented with prostate cancer at late stages.

00:56Let's talk about treatment itself.

00:59So when people start thinking about late-stage cancer, they think about death.

01:04However, prostate cancer is quite peculiar,

01:07in the sense that it is controlled by hormone,

01:11and when men are deprived of testosterone, then the cancer stays dormant for a long time.

01:18What it means is that even if you are presented with late-stage prostate cancer,

01:23you do not go into a doom period of short-term life expectancy and subsequently death,

01:32and a lot of prostate cancer can be controlled by hormonal suppression.

01:37So the hormonal suppression can be done several ways.

01:40The old way of doing it is castration,

01:43meaning that we remove both testicles to deprive the men of testosterone.

01:48Other newer method is injecting a type of medicine called LHRH agonist.

01:56LHRH is a hormone produced by the brain.

02:00If you inject this agonist, then it will trick the brain to suppress the production of such hormone,

02:07as a result and shrinkage and the reductions of the production of testosterone from the testicle.

02:14Apart from that, other way of doing it is to take medicine which is an anti-androgen,

02:20and then this medicine can suppress it.

02:23Although it sounds quite cruel that you castrate a man or medically castrate a man,

02:29the reality is that men will experience the same problem as women when they undergo menopause.

02:36So the hot flushes, night sweating will all emerge just like how it happens in a woman.

02:42So it's not too dramatic.

02:44However, things to take into account will be osteoporosis,

02:48because without the testosterone, a man's bone become quite brittle,

02:52and therefore we need to protect the bone strength.

02:55For men who subsequently develop castration-resistant prostate cancer,

03:01then there are several drugs that are available to control it,

03:04but the end stages of cancer itself can be quite horrible

03:08in the sense that it will cause a man to be anemic, fracture bone,

03:13constipation because of enlarged prostate causing obstruction of the bowel,

03:17and also retention of urine.

03:20So obviously to avoid all these, the way is to get screened,

03:24and to avoid late stage prostate cancer, and to avoid castration altogether.

03:30So for the month of December, I think we're going to make it a bit light-hearted.

03:34We're going to deal with myth of cancer and also other men's health subjects.

03:39The first one that we're going to deal with is vasectomy associated with prostate cancer.

03:45If you're concerned about such myth, and you're interested to find out,

03:49stay tuned for next week's Putting Dr. G on the Spot.

04:00For more information visit www.FEMA.gov

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