Cancer management is complex and usually requires joint decision of urologist, medical oncologist, radiation oncologist, pathologist and radiologist. All complex urology cancer cases here are discussed in a multidisciplinary tumour board. In the case of rare and challenging cases where there is limited experience locally, case can be discussed online in an international tumour board comprising of specialists from Singapore and the region.

Unlike other cancer that have shown evidence of spread to other organ, first line of treatment for metastatic prostate cancer is usually hormonal treatment. The aim is to lower the testosterone in the patient's body as testosterone is the main source of growth for prostate cancer. Hormonal treatment can be done surgically or medically. Surgical treatment involves removal of both testes(orchidectomy - please see below for more information.

Medical treatment is usually in the form of 3 monthly injection or oral tablets. Most patients tolerate hormonal treatment quite well.

Side Effects of Hormone Treatment

• Impotence (inability to have an erection)
• Loss of libido
• Hot flushes and sweats
• Breast soreness and swelling
• Tiredness and weakness

Side Effects of Hormones after Longer-Term Treatment

• Weight gain
• Mood swings
• Thinning of the bones
• Increased risk of heart disease and diabetes

Side effects of hormonal treatment can be minimized by maintaining healthy weight, regular exercise and exposure to sunlight.

Removal of a testis (or testicle). This may be performed either via a skin incision in the groin (for potential testicular tumour) or through the scrotum (for non-cancerous causes).

Surgery is usually done under a short general anesthesia.