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Doctor On Call (DOC): Dr Lee Fang Jann – Men’s Health (Part 1)

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Doctor On Call, or DOC for short, is a brand new series brought to you by Medical Channel Asia. This series aims to bring doctors and specialists from various fields to give you an introduction to common health and medical topics that you and the Asian population are interested in. In our 2nd DOC, held on 18 Jun (Friday), from 8pm to 9pm (GMT+8), we have Dr Lee Fang Jann, urologist and renal transplant surgeon from UroDoc, to talk to us about Men’s Health.

For Part 1 of the forum, we have Dr Lee give us a short presentation on the common issues surrounding men’s health, such as the prostate function and sexual health. In Part 2, Dr Lee answers some of the questions posted LIVE by our audience. Read below to find out what more about men’s health and the common urological problems regarding men!

Presentation by Dr Lee Fang Jann

What is urology?

Urology is a branch of medicine that deals with the urinary tract system. This system helps to treat waste product and pass off excess water. It consists of the kidneys, ureter, bladder and urethra.

Some common urological conditions that a urologist treat include:

  • Urological cancers: including kidney cancer, bladder cancer, and prostate cancer
  • Urinary stones: little stones in the urinary tract, typically with dehydration. When within the kidneys, there are usually asymptomatic. But when the stones are being passed out, it will become very painful, as they get lodged in the ureters. Common cause of presenting at emergency department
  • Kidney transplant: a procedure whereby a patient with kidney disease such as end stage renal failure require a kidney replacement programme. Kidney transplant may provide a better quality of life
  • Urinary incontinence and urinary tract infections
  • Male reproductive tract: consists of penis, testes and prostate. The tract that is involved in the production, storage and transport of semen.
    • Erectile dysfunction (ED) or impotence: problem maintaining rigidity and hardness for sexual penetration
    • Premature ejaculation: condition whereby a man ejaculates too early
    • Male infertility: conditions whereby a couple who are trying to conceive are unable to, and the male partner is having problems with quantity and/or quality of sperms
    • Testosterone deficiency syndrome: testosterone depletes to too low a level and affects quality of life. This affects sex drive, more fatigue, ED, muscle mass, increased visceral body fat, testicular atrophy, osteoporosis, loss of facial, axillary and pubic hair

Prostate health

A prostate gland is a walnut sized male organ that is located at the base of the bladder, through which urine flows through, connecting to the penis. It is the junction of both the male urinary and reproductive system.

The main function of the prostate is to provide fluids to nourish and protect the sperms.

Signs of prostate condition are mostly urinary in nature:

  • Incomplete bladder emptying
  • Frequent urination at night
  • Weak or intermittent urine stream
  • Blood in urine
  • Constant urge to urinate

Benign Prostate Hyperplasia (BPH)

Unavoidable condition as we get older, where the prostate gland enlarges. It blocks the calibre of the urinary system, like turning off the tap. It hits about 90% of the population by the time they are 80 years old.

Prostate cancer

Prostate cancer is 2nd most common cancer in Singapore, behind colorectal cancer. 1 in 8 men will develop prostate cancer in his lifetime.

Stages of prostate cancer

  • Stage 1: cancer is confined within the prostate
  • Stage 2a, 2b, 2c: enlargement of the cancer
  • Stage 3: invades outside the prostate and into the surrounding organs like bladder
  • Stage 4: late stage, breaks off and spread to other parts of the body

Symptoms of prostate cancer

Symptoms of prostate cancer can be very similar to prostate enlargement:

  • Weak or interrupted flow of urine
  • Sudden urge to urinate
  • Trouble starting urination
  • Painful/ burning sensation
  • Blood in the urine or semen (especially if it has invaded into the lining)
  • Pain in the back, hips or pelvis (if it has broken off and spread to the bone)
  • Breathlessness, tiredness, dizziness, anaemia (if it has spread to the lungs, bone marrow)

Early prostate cancer has no symptoms! Symptoms only manifest as the cancer enlarges till it impeach onto the urinary lining, hence it has symptoms very similar to prostate enlargement. The best time to treat it is when it is at early stage, much like any other diseases.

Risk factors of prostate cancer

  • Age: Men over age of 50 years old
  • Ethnicity: Men of African-Caribbean and African descent, followed by Caucasians
  • Family History: Hereditary genetic mutations

Diagnosis of prostate cancer

  • Prostate specific antigen (PSA): a blood biomarker that can be done via a simple blood test. If elevated, you may want to examine further.
  • Digital rectal examination (DRE): a physical examination. To assess the prostate, physicians insert a gloved finger to feel for the size of the prostate gland, and surface of the gland to see if there are any nodular surfaces.

Age to consider checking

  • General population: from 50 years old
  • Family history of prostate cancer: from 45 years old

The age above is with regards to screening, in the absence of symptoms. If you have urinary symptoms, you should go see a urologist as soon as possible, to rule out the possibility of prostate cancer.

Early detection of prostate cancer saves lives. If you pick up prostate cancer at stage 1, you have a higher chances of survival (5-year survival rate of 93%). If it is picked up at stage 4, the 5-year survival rate is only at 38%.

Medical insurance claims

If we are to seek medical help, what are the ways and options available with regards to insurance?

  • General exclusions: sexual dysfunction (e.g. erectile dysfunction) and cosmetic procedures
  • MOH Chronic Disease management Programme (CDMP): Inclusive of BPH, up to $500/year
  • Corporate specialist outpatient cover
  • Hospitalisation plans
  • Critical illness plans
  • Integrated shield plans
    • MediShield Life: sufficient coverage for large bills in class C or B2
    • Additional private insurance coverage: higher coverage for cost of stay in private hospitals, class B1 or Class A wards in public hospitals

Take home messages with regards to men’s health

The following are things that you can see a urologist for:

  • Common urological conditions: urinary stones, incontinence
  • Common men’s health conditions: sexual dysfunction, fertility issues
  • Prostate conditions: prostate enlargement, prostate cancer

Early detection of prostate cancer saves lives. Not just to see a urologist when you only have urology symptoms. It is important to consider doing early checks to get a better chance of cure.

What’s next in store?

  • See Part 2 for the Question and Answer (Q&A) segment with Dr Lee Fang Jann!
  • See the full video on both our Medical Channel Asia’s Facebook page and our Medical Channel Asia’s YouTube channel:

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