When prostate care gets smarter
When Filipinos talk about Singapore, we usually think of shopping, food, efficient public transport and that enviable sense of order. But during a recent visit, I found myself looking at Singapore through a different lens—as a Filipino journalist invited to learn about its healthcare system.
And perhaps the thing that struck me most was not simply how sophisticated Singapore’s hospitals are. It was the idea that world-class healthcare is not meant only for the wealthy or well-connected.
Singaporeans are fortunate to have a healthcare system in which government subsidies and a structured public healthcare network help make medical care more accessible to ordinary citizens. Patients can enter the system through public polyclinics for subsidized care, while those who prefer private consultations and the freedom to choose a particular specialist can opt to pay private rates. Emergency departments provide another entry point when urgent care is needed.
At the heart of this system is SingHealth, Singapore’s largest public healthcare group, with Singapore General Hospital as its flagship institution.
SGH may be the oldest hospital in Singapore, but “oldest” certainly does not mean old-fashioned. With more than 46 specialties and subspecialties, it is part of a vast network of centers of excellence, with its reach extending beyond one hospital campus to other hospitals and polyclinics serving communities across Singapore.
Listening to the SingHealth team explain this system, I found myself thinking about the Philippines.
At Singapore General Hospital, smarter prostate care means doing less — fewer needles, fewer incisions and less time in the hospital.
We, too, have excellent doctors. We have brilliant specialists, dedicated healthcare workers and medical institutions capable of delivering highly advanced care. But access remains one of our biggest challenges. For many Filipino families, the question is not simply, “What is the best treatment available?” It is also, “Can we afford it?”
That is what makes Singapore’s healthcare model worth looking at—not simply because its hospitals are technologically advanced, but because of the system behind the medicine.
And that became one of the larger themes of the medical conference I attended: health is not only about discovering the latest treatment. It is also about building systems that allow people to benefit from those advances.
For this article, I looked more closely at urology—a field that may sound highly specialized but actually touches some very ordinary concerns, particularly as men grow older: prostate problems, urinary difficulties and, most seriously, prostate cancer.
SingHealth’s message was refreshingly straightforward: being good is not enough. The goal is to keep learning, sharing knowledge and working with neighboring countries so that healthcare improves not just in Singapore, but across the region.
For Filipinos, there is much to learn from that philosophy. Because the real measure of a healthcare system isn’t only how advanced its hospitals are. It is how many people can actually benefit from them.
Rethinking prostate cancer surgery
If there is one area where SGH’s approach to urology caught my attention, it is prostate cancer.
For many men, even talking about the prostate can be uncomfortable. The possibility of cancer—followed by a biopsy, surgery and days in a hospital—can be even more daunting.
But associate professor Dr. John Yuen Shyi Peng, head and senior consultant of SGH’s Department of Urology, says his team is finding ways to make prostate cancer care less invasive and easier on patients.
One example is how they approach diagnosis.
Using prostate MRI and PSMA imaging, SGH is exploring whether carefully selected patients with highly indicative scans can be diagnosed and treated without first undergoing a biopsy. In an initial group of 15 patients who met the strict criteria, all were confirmed to have prostate cancer after surgery.
It is still a highly selective approach, Prof. Yuen stressed. But for the right patient, skipping a biopsy could mean avoiding an invasive procedure, its potential complications and the added cost.
For patients who do need a biopsy, SGH has also adopted a less infection-prone approach. Instead of passing the needle through the rectum, doctors enter through the skin between the scrotum and anus. The transperineal approach avoids the bacteria-rich rectum and substantially reduces the risk of infection.
Then comes the surgery.
SGH performs robotic prostate surgery through an extraperitoneal approach, working outside the abdominal cavity rather than disturbing the intestines. For patients, the technical difference can have a very practical benefit: they may be able to eat, walk and recover more comfortably soon after surgery.
The surgeons have also reduced the number of incisions. Instead of the five or six small wounds commonly used in robotic prostate surgery, suitable patients may need only one to three, depending on the complexity of the operation.
And perhaps the most surprising part: some patients can go home the same day.
In his talk, “When Patients Fly Home: Safe Repatriation After Robotic Prostatectomy,” Dr. Yuen shared that SGH has developed a pathway “allowing suitable patients to leave within 23 hours, provided they can eat, drink and walk independently, have their pain controlled and show no significant bleeding or other complications.” About 90 percent of patients assessed under the pathway meet these criteria within 23 hours.
For international patients, including those from the Philippines, recovery does not necessarily mean staying in a hospital. Patients generally remain in Singapore for about 10 days, recovering at a hotel with a family member until the catheter is removed and the surgeon completes a final review. In appropriate cases, SGH can coordinate catheter removal and follow-up with a doctor in the patient’s home country.
All these advances—the imaging, robotic surgery, fewer incisions and shorter hospital stay—point to one goal: less pain, less disruption and a faster return to normal life.
But perhaps the most important lesson from Prof. Yuen has nothing to do with robots.
Prostate cancer can be silent in its early stages. By the time symptoms appear, the disease may already be advanced. That is why men should talk to their doctors about Prostate-specific Antigen (PSA) screening, particularly from around age 45 and earlier or more frequently if they have risk factors such as a strong family history.
Don’t wait for symptoms
The fight against prostate cancer begins long before surgery. The disease is often silent in its early stages, with few or no warning signs. By the time urinary problems or other symptoms develop, the cancer may already have progressed.
That is why Dr. Yuen stresses the importance of PSA screening.
PSA is measured through a simple blood test. It does not automatically mean a man has cancer, but it can help doctors determine whether further investigation is needed and how often he should be screened.
According to Dr. Yuen, international guidelines generally recommend that men discuss PSA screening with their doctors from around age 45.
It is a conversation many Filipino men may be tempted to postpone. Some are more comfortable ignoring changes in their bodies than talking about them. Others assume that getting up several times at night to urinate is simply part of growing older.
But that is precisely why awareness matters. A PSA test is relatively simple. The harder part, sometimes, is making the appointment.
Don’t wait until your body forces you to pay attention.
Beyond the technology
What impressed me about SGH’s urology program was not the technology alone, but the thinking behind it.
The department combines patient care with research, education and collaboration, sharing its expertise with doctors and institutions beyond Singapore. Its specialists also travel internationally to teach robotic prostate surgery and exchange clinical experience.
For Singaporeans, there is also a broader safety net. Eligible citizens receive government subsidies for prostate cancer surgery, helping make treatment more accessible.
During the conference, I was also pleased to meet two Filipino doctors: Dr. Diosdado C. Limjoco of St. Luke’s Medical Center–Quezon City and Dr. Ana Melissa Cabungcal of Makati Medical Center. Their presence underscored an important point: medical knowledge does not stop at borders. Conferences like this allow physicians to exchange ideas, compare approaches and ultimately improve patient care.
For Dr. Limjoco, the value of such gatherings extends well beyond learning about new technologies.
“Being invited to this medical conference is very important because it strengthens collaboration and coordination in managing complex and even rare cases that we encounter in the Philippines. When needed, we can refer our patients to specialized centers like Singapore General Hospital so there is continuity in the treatment protocol we’ve started.”
His observation echoed one of SingHealth’s central messages: advances in medicine are driven not only by innovation, but by collaboration and the willingness to share knowledge across borders.
The message is much simpler: know your risk, talk to your doctor, ask about PSA screening when appropriate, and don’t dismiss changes in your urinary health as “normal” simply because you’re getting older.
Because when it comes to prostate cancer, early attention can make all the difference.
