When Life Throws You A Curve Ball

When Life Throughs You A Curve Ball | Focal Therapy Prostate Cancer Patient Story

Instead of being overly worried when diagnosed with stage two prostate cancer, Mr. Tan Kee Liong balanced it out by maintaining some semblance of normality, and a sense of control.

Read on as we speak to Mr. Tan to find out more about his journey with prostate cancer, from diagnosis to treatment.

Mr. Tan is all about having a balanced lifestyle and fitness. While he is an engineer by training, outside of work, Mr. Tan can always be found outdoors either jogging, hiking, or swimming. Even at 59, he enjoys music, occasional drumming, and karaoke. He would usually watch his diet as he has high cholesterol. According to him, he finds it most satisfying to enjoy a day of steak for cheat meals.

High Prostate-specific Antigen (PSA) Readings

According to Mr. Tan, he does his health screening regularly but missed out the PSA test for years. When he finally took the PSA test in December 2019, he received unexpected results.

“When the PSA results came back, my doctor said the reading is higher than the acceptable range. He also cautioned that the test results is non-conclusive as there could be many underlying reasons,” Mr. Tan shared.

He was then prescribed two weeks’ worth of antibiotics before repeating the PSA test. However, the readings still came back higher than before. It was then that his health screening doctor referred him to a urologist at the National University Hospital (NUH) for further check. What follows was a string of tests to check if the high PSA readings is due to cancer.

In addition to the general check-up and blood tests at NUH, I also went for an MRI and prostate scan in June last year. The scans came back indicating there was some swelling of the prostate nodules. I was advised to do a biopsy to confirm if it is cancerous,” he added. It was not until in September 2020 that Mr. Tan finally got his appointment to do the biopsy.

"Since I had about three months before my biopsy, I decided to find out more on my own. I asked people whom I know and they all felt that prostate cancer is gradual and probably is less aggressive compared to other forms of cancer. Instead of getting worried and be preoccupied with the uncertainty of the condition, I continued maintaining a healthy lifestyle by exercising regularly, watching my diet and try to relax a little. Furthermore, during the prostate exam, my doctors said my prostate is still alright in terms of the shape and size. It gave me confidence to believe that everything will be alright, too," he shared.

The Diagnosis

Two weeks later, Mr. Tan’s biopsy confirmed that he has stage two prostate cancer. Instead of feeling shocked or wallowing over the “why me” question, he went about the matter ‘scientifically,’ to find out more about prostate cancer and available treatment options.

“Maybe it was with some optimism that my prostate cancer is localized and to some extent, more manageable. It also gives some me some assurance that I could have more time to think through the various treatment options,” he explained.

“The major thing that confronted me at that time were the treatment options. There is the surgery, and radiography which my specialist doctor at NUH advised. When I was at the National Cancer Centre, they recommended radio therapy to aggressively treat the cancer. As there was no symptom; and I thought about how cancer was still in its early stage, I wanted to look at other options.”

In October 2019, Mr. Tan did another bone scan which confirmed that the cancer is still localized, which means it has not spread outside the prostate.

The Search For Alternative Treatments

“While looking for alternative treatments on the internet, I came across news about focal therapy with mentions of Dr. Chong Kian Tai,” Mr. Tan. shared. “I then got in touch with Dr. Chong and consulted him for a review of my condition. After listening to Dr. Chong’s explanation and reading up more information, I decided to go for the procedure. It took place at the end of October 2019,” Mr. Tan recounted.

“Majority of our patients with prostate cancer do not show symptoms and they actually feel perfectly fine. They may not have any urine problems, nor has blood in the urine. That was how Mr Tan was when I saw him at the clinic.” Dr. Chong Kian Tai, Consultant Urologist at Farrer Park Hospital said.

Asked how patients are determined for their suitability for focal therapy treatment, Dr. Chong said:

“When prostate cancer is detected early, the cancer cells may still be growing slowly. Sometimes, we don’t treat it. Instead, we conduct active surveillance to monitor and control the condition. However, there are some early-stage prostate cancer that needs treatment. One possible treatment option is focal therapy, which treats patients whose prostate cancer cells are localized. In Mr Tan’s case, since his cancer is localized, he is suitable for the procedure.”

Focal Therapy for Early Stage Prostate Cancer

Focal therapy for prostate cancer targets and selectively destroys cancerous cells within the prostate using high intensity focused ultrasound (HIFU). The minimally invasive treatment allows the prostate to be preserved as only the cancerous cells are treated. This allows men to preserve their prostate function. Most patients who underwent the treatment do not experience urine leak as well. A multicenter research study from the United Kingdom was published in the European Urology medical journal in 2018, with results of the 5-year outcome. Results shows that 98% of patients achieved complete urine control.

Mr. Tan was very determined to make sure he is fit for the procedure and good recovery. “Other than stepping up my exercise routine, I am also more conscious of my lifestyle and nutrition. As much as possible, I made sure that my sleep is sufficient,” he said.

Going Through the Procedure

When asked how he prepared for the treatment, Mr. Tan shared that he was very determined in making sure he stays fit for the procedure so as to enjoy a good post-operation recovery.

“Besides stepping up my exercise routine, I was also more conscious of my lifestyle and diet. As much as possible, I made sure that I get sufficient sleep,” he said.

Mr. Tan went through the procedure under general anesthesia. “Other than the discomfort in the abdominal area, I felt fine when woke up. Since the procedure took place the evening, I stayed one night in the hospital for observation.,” he recounted.

Post Operative Care

Post operative care and recovery were the next big thing for Mr. Tan. Like most patients, Mr. Tan had to wear a urinary catheter to help empty the bladder while the swollen prostate continues to heal. While this is only for a short period, Mr. Tan also had to undergo bladder retraining after removing the catheter because the urinary system needed to adjust to the new situation.

“After wearing the catheter for about two weeks, my bladder and muscles were not accustomed to naturally pass urine. I experienced difficulty. I realized I also drank too much water before I went to bed the first night the catheter was removed,” he recounted.

Instead of feeling frustrated and anxious, Mr. Tan took things in good stride. “I normally would try to understand the reason and then I would just basically take it as a process, ” he said candidly. Mr. Tan paced himself, moderated his water intake, and got quality sleep for a couple of days to retrain his bladder. Another adjustment for Mr. Tan was showering with the catheter and when passing motion. “I try not to eat too much meat; just the usual. During this period, I also exercised less as I didn’t feel like walking around while wearing the catheter,” he said. 

Now that five months have passed since receiving focal therapy, Mr. Tan has to follow-up with a PSA test every three months as part of treatment monitoring. Asked for his thoughts on the overall treatment journey, Mr. Tan said:

"For cancer patients, aiming for remission is certainly a key priority. Likewise for myself. With new medical technologies, early detection and treatment, I am optimistic of positive outcome.  I look forward to that day when I am completely in remission."

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This Article Was Reviewed By:

Dr. Chong Kian Tai (张建泰医生) is a certified Urologist who manages both General Urology and complex Urologic Cancers. He is a Specialist Urology Surgeon who is skilled in working with different treatment choices for optimal outcome. Treatments he is proficient in include traditional open surgery, advanced keyhole laparoscopic and endoscopic surgery, as well as the modern da Vinci Robotic Surgical Systems.

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