Prostate cancer stands as the third most common cancer among Malaysian men, with 70 percent of cases diagnosed at advanced stages. This delayed detection significantly reduces the chances of successful treatment and survival.
Since cancer therapies are expensive, it underscores the urgent need for both enhanced early detection methods and cost-effective treatment options to improve outcomes for Malaysian prostate cancer patients.
Malaysia, meanwhile, is emerging as a prominent leader in adopting advanced prostate cancer treatments and diagnostics, including Prostate-Specific Membrane Antigen (PSMA) PET scans and Stereotactic Body Radiotherapy (SBRT), in its hospital setting.
PSMA PET scans, for instance, enable precise detection of prostate cancer even in its earliest stages, improving diagnostic accuracy and enabling timely interventions.
On the other hand, SBRT delivers high doses of radiation with exceptional precision, significantly reducing the impact on surrounding healthy tissues and shortening treatment durations.
Unlike conventional imaging methods, such as biopsies, ultrasounds and standard imaging techniques – which take a longer duration – these modern technologies offer quicker diagnoses and more efficient treatments, according to medical experts.
AN INNOVATIVE APPROACH
Dr Lingeswaran Kasilingam, consultant nuclear medicine physician at Beacon Hospital in Petaling Jaya, said PSMA PET scans target the PSMA receptor, a protein abundantly expressed on prostate cancer cells. This allows for high-resolution imaging capable of detecting even the smallest cancerous lesions.
Compared to traditional methods like bone scans and others, PSMA PET scans offer greater sensitivity, efficiency and accuracy. It can also identify lesions as small as 0.3 centimetres, detecting cancer at stages where conventional imaging might miss it.
“The sensitivity of PSMA PET scans not only improves the accuracy of a diagnosis but also enables doctors to tailor interventions with precision, avoiding over-treatment or under-treatment and ultimately improving patient outcomes.
“Traditional bone scans, for example, require higher doses of radiotracers and longer imaging times. In contrast, PSMA PET scans use lower doses (4-5 milliCurie/mCi) and can achieve full localisation in about an hour, reducing imaging time to just seven to eight minutes.
“This efficiency enhances patient comfort and improves overall clinical workflow,” he said when met by Bernama after a special discussion on medical advancements in prostate cancer organised by Novartis Malaysia, recently.
He said PSMA scans can also detect molecular changes that occur before visible anatomical abnormalities, which makes it easier to distinguish between cancerous lesions and benign conditions such as arthritis or fractures, improving diagnostic precision.
The reduced radiotracer dose also minimises long-term radiation exposure, making PSMA PET scans much safer for patients who may require follow-up scans.
“PSMA PET scans also play a vital role in monitoring prostate cancer after treatment. When prostate-specific antigen (PSA) levels rise, conventional imaging may miss small recurrent lesions. However, PSMA scans can identify even the smallest areas of recurrence, ensuring that timely interventions are made to control the disease and improve outcomes. This capability allows for more precise disease management, contributing to better long-term survival rate,” he added.
SBRT THE ‘SNIPER’
SBRT is considered another transformative development in the treatment of prostate cancer. As explained by Datuk Dr Mohamed Ibrahim A Wahid, consultant clinical oncologist and medical director at Beacon Hospital, SBRT delivers highly targeted radiation with sub-millimetre precision, minimising damage to healthy surrounding tissues. This technique significantly reduces side effects and improves patient outcomes, all while reducing treatment time.
Unlike traditional radiotherapy, which often requires daily sessions over several weeks, SBRT can complete treatment in just five sessions or fewer. This streamlined treatment process minimises disruption to patients’ daily lives and reduces complications such as bowel or bladder irritation, improving the patient’s quality of life during and after treatment.
“The integration of advanced technologies has also further enhanced the precision of SBRT, improving treatment effectiveness, reducing side effects and shortening recovery time,” he added.
According to Dr Mohamed Ibrahim, the combined use of PSMA PET scans and SBRT are revolutionising how prostate cancer is diagnosed and treated, adding SBRT’s success rate is quite remarkable, boasting a five-year control rate of 95 to 97 percent.
Another promising treatment for advanced prostate cancer is Radioligand Therapy (RLT), which involves the use of therapeutic radioisotopes that target PSMA receptors on cancer cells, delivering targeted radiation while sparing healthy tissues.
“This therapy has shown significant potential, particularly for patients with metastatic prostate cancer who have exhausted other treatment options,” he said, adding clinical trials have been underway since 2017 to assess the effectiveness of RLT.
Stressing that early detection remains crucial for improving prostate cancer outcomes, Dr Lingeswaran said men aged 50 and above, especially those with a family history of prostate cancer, should prioritise regular screenings.
Symptoms to watch out for include frequent urination, difficulty starting or stopping urination, weak or interrupted urine flow, blood in the urine or semen, and pelvic pain.
“We would also like to emphasise that early detection through PSA tests, digital rectal exams and PSMA PET scans is vital to improving survival rates and quality of life,” he added.
MEDICAL TOURISM HUB
Meanwhile, the availability of advanced cancer treatments such as SBRT and PSMA PET scans is among the reasons Malaysia has gained recognition as a leading destination for medical tourism.
According to Dr Mohamed Ibrahim, another reason for Malaysia’s growing popularity as a medical tourism hub is its ability to offer world-class care at a fraction of the cost charged by neighbouring countries.
He said the cost of a PSMA PET scan is much lower in Malaysia than in countries like Indonesia or Singapore. Similarly, SBRT is available at a considerably lower cost in Malaysia compared to countries like Singapore and Australia, where it may be out of reach for many patients.
“This cost-effectiveness, combined with the high quality of care, has led to an increasing number of international patients choosing Malaysia for specialised cancer treatments.
Dr Mohamed Ibrahim said Malaysia’s early adoption of advanced therapies, such as SBRT, has helped establish the country as a regional leader in cancer care, attracting patients from Australia, Iran, Indonesia and other countries.
“The future of prostate cancer treatment in Malaysia looks promising, with a focus on precision medicine, cost-effective treatments and improved patient outcomes.
“By embracing innovative diagnostic and treatment technologies, the country is not only enhancing the survival rates and quality of life for its own citizens but also establishing itself as a global leader in medical tourism for cancer care.”
