Size does matter
However, it and other symptoms, such as difficulty urinating, are often dismissed as normal signs of ageing.
In Malaysia, prostate cancer is the third most common cancer among men and as Malaysia shifts towards an ageing nation, more men will be at risk.
Yet, close to three-quarters of cases are diagnosed in advanced stages, where complications are more severe, treatment options limited and survival rates significantly reduced.
Prostate cancer is insidious, often silent and frequently ignored until it's too late, says Sunway Medical Centre consultant urologist Professor Dr Tan Guan Hee.
"Yes, size usually matters. When the prostate is enlarged or urinary symptoms appear, that should trigger a check, not a shrug," he adds.
"The assumption that it's just ageing can delay diagnosis and lead to poorer outcomes."
Dr Tan says the five-year relative survival rate for stage 4 prostate cancer is only 43.2 per cent, according to the Malaysian Study on Cancer Survival — a stark reminder of the price of late diagnosis.
Critical gaps remain in how Malaysian men approach prostate health, including delayed symptom recognition, where urinary changes or an enlarged prostate are often ignored instead of investigated.
Many cases are only detected when the disease is advanced, potentially due to the limitations of conventional imaging methods which can miss small or early metastases.
Limited awareness of advanced diagnostic and treatment options is also a factor.
Addressing these gaps is key, particularly as Malaysia's population continues to age.
"When patients are diagnosed early, their chances of survival and quality of life significantly improve."
The challenge is ensuring men seek medical help before the disease becomes aggressive and spreads to the bone, says Sunway Medical Centre consultant clinical oncologist Dr Nik Muhd Aslan Abdullah.
A promising innovation in terms of treatment, meanwhile, is theranostics — a dual approach that combines targeted imaging with targeted therapy.
The use of theranostics, along with greater awareness and screening efforts, could help reverse current trends by detecting what conventional methods might miss and improve quality and duration of life after treatment, even among those with advanced or metastatic cancer.
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