Prostate Cancer Treatments in Asia: Surgery, Hormonal Therapy, and Emerging Drugs

Prostate cancer is one of the most common cancers in men worldwide, and its incidence in Asia is steadily rising due to aging populations, lifestyle changes, and increased screening. Treatment strategies range from surgery and radiation to hormonal therapy, chemotherapy, and newer targeted and immunotherapies. This article explores prostate cancer treatments in Asia, highlighting challenges, innovations, and future trends.

Prostate Cancer in Asia: Epidemiology

• Global statistics: Over 1.4 million men are diagnosed annually with prostate cancer.
• Asia’s trends: Japan and South Korea: High detection rates due to PSA screening. China and India: Rapidly increasing cases, but often diagnosed late. Southeast Asia: Lower incidence but rising steadily with westernized lifestyles.
• Risk factors: Age (most cases in men over 60). Genetic predisposition (family history). High-fat diets and obesity.

Surgery

Radical Prostatectomy

• Removal of prostate gland, seminal vesicles, and nearby tissues.
• Open surgery still performed in many Asian hospitals.
• Minimally invasive approaches: Laparoscopic prostatectomy widely adopted in Japan and South Korea. Robotic-assisted surgery (Da Vinci system) growing rapidly in China, Singapore, and India.

Regional Access

• Japan and South Korea: Advanced robotic techniques widely available.
• India: Rapid expansion of robotic centers; affordability remains a challenge.
• Rural Asia: Limited access, many men present too late for surgery.

Radiation Therapy

• External Beam Radiation Therapy (EBRT): Widely available in urban Asia.
• Brachytherapy: Radioactive seeds implanted in the prostate; popular in Japan and Singapore.
• Proton Therapy: Advanced centers in Japan and South Korea; expanding in China.

Hormonal Therapy (Androgen Deprivation Therapy – ADT)

Medical Castration

• LHRH agonists (leuprolide, goserelin) and LHRH antagonists (degarelix) suppress testosterone.
• Widely used as first-line treatment in advanced prostate cancer.

Surgical Castration

• Orchiectomy still used in low-resource settings.

Anti-Androgens

• Bicalutamide, enzalutamide, apalutamide block androgen receptor signaling.
• Newer-generation drugs increasingly available in Japan, South Korea, and China.

Chemotherapy

• Docetaxel remains the standard for metastatic castration-resistant prostate cancer (mCRPC).
• Combination with ADT shown to improve survival.
• Accessibility limited in lower-income regions of Asia.

Targeted Therapy and Immunotherapy

PARP Inhibitors

• Olaparib and rucaparib for men with BRCA-mutated prostate cancer.
• Japan and China expanding access through clinical trials.

Immunotherapy

• Sipuleucel-T (cancer vaccine) limited in Asia.
• Checkpoint inhibitors (nivolumab, pembrolizumab): Trials ongoing in Japan, South Korea, and China.

Radioligand Therapy

• PSMA-targeted therapy emerging in advanced cases; early adoption in Japan and India.

Regional Insights

• Japan: Advanced infrastructure, widespread robotic surgery, early adoption of targeted drugs.
• South Korea: Strong screening programs, high use of minimally invasive techniques.
• China: Rapidly rising incidence, expanding access to immunotherapy and precision oncology.
• India: Growing demand; affordability challenges for newer drugs.
• Southeast Asia: Limited resources; majority of cases diagnosed late.

Challenges in Asia

1. Low Screening Rates: PSA testing not widely adopted in many countries.
2. Late Diagnosis: Many patients present with metastatic disease.
3. High Costs: Targeted drugs and immunotherapy remain unaffordable.
4. Healthcare Inequality: Major urban-rural disparities.

Future of Prostate Cancer Treatment in Asia

1. Expansion of PSA screening programs for early detection.
2. Precision medicine: Genetic profiling to identify BRCA and other mutations.
3. Greater access to advanced therapies through generics and biosimilars.
4. AI-driven imaging for early detection and treatment planning.
5. Policy support: National cancer programs to improve affordability.

Conclusion

Prostate cancer is a growing health concern in Asia, with incidence rising due to aging and lifestyle changes. Advances in surgery, radiation, hormonal therapy, chemotherapy, targeted drugs, and immunotherapy are improving outcomes, but disparities remain.

The future of prostate cancer care in Asia lies in early detection, wider access to advanced treatments, and integration of precision medicine, ensuring men across the region receive timely and effective care.

Written by:MedCure Asia Editorial Team
The MedCure Asia Editorial Team specializes in delivering accurate, well-researched health insights across Asia. Our mission is to provide readers with trusted guidance on medical conditions, treatments, and wellness practices.