Prostate Problems: Knowing the Difference Between BPH and Cancer

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As men age, they may find themselves dealing with prostate issues such as benign prostatic hyperplasia (BPH) or even prostate cancer¹.

While both can be concerning, it’s important to understand the differences between BPH and prostate cancer in order to properly identify symptoms and catch these conditions early.

What Is Benign Prostate Hyperplasia?

Benign prostate hyperplasia, or BPH, is a common condition that affects nearly half of all men over the age of 50². As prostate cells in the gland enlarge, they press against the urethra of the male reproductive system³.

What Is Prostate Cancer?

Prostate cancer is a malignant tumour that results when abnormal cells start to multiply within the prostate tissue. As it grows, cancer cells can spread and cause serious health problems if not identified and treated early⁴.

What Are the Risk Factors for BPH and Prostate Cancer?

Several risk factors can increase a man's risk to developing prostate cancer or BPH. These risk factors include⁵:

1. Age: The risk increases significantly after the age of 50 due to prostate gland growth and cellular changes.

2. Family history: The risk is increased, particularly if there is a close relative who has prostate cancer or BPH.

3. Race: Prostate cancer occurs most frequently in African American men and is more likely to progress to aggressive forms.

4. Obesity: The hormones and inflammation that contribute to obesity also increase the risk of prostate cancer and BPH.

5. Smoking: Due to its negative effects on DNA, oxidative stress, and inflammation, smoking has been linked to an increased risk of developing aggressive forms of prostate cancer.

Symptoms of BPH

The symptoms of BPH are related to the pressure that the enlarged prostate places on the urethra⁶. These symptoms include:

• Weak urine flow

• Difficulty starting or stopping urine flow

• Increased frequency of urination

• Feeling of incomplete bladder emptying

• Urinary urgency

• Dribbling after urination

Symptoms of Prostate Cancer

Early-stage prostate cancer may not cause any symptoms. However, as the cancer grows, it may cause urinary symptoms similar to those of BPH, as well as⁷:

• Blood in the urine or semen

• Erectile dysfunction

• Painful ejaculation

• Pain in the back, hips, or pelvis

Getting Prostate Cancer and BPH Diagnosed

When seeking medical attention for an enlarged prostate, your healthcare provider will begin by asking questions and performing a physical exam, which includes a digital rectal exam to assess the prostate's size. They may also conduct a urine test or a prostate-specific antigen (PSA) blood test to detect prostate cancer or any other illnesses⁸.

After that, you might need other tests to help confirm an enlarged prostate, such as⁸:

• Urinary flow test

• Postvoid residual volume test

• 24-hour voiding diary

If your health problem is more complex, you may need further exams such as transrectal ultrasound and prostate biopsy.

How Are Prostate Cancer and BPH Treated?

The treatments for BPH and prostate cancer depend on the type and severity of the condition. 

For benign prostatic hyperplasia treatment, doctors may recommend⁹:

• Watchful waiting: Schedule regular appointments to monitor your condition.

• Transurethral resection of the prostate (TURP): A procedure in which a surgeon removes part of the prostate through the urethra.

• Transurethral incision of the prostate (TUIP): Involves making small cuts in the bladder neck.

• Transurethral electrovaporisation: An energy source is used to vaporise the excess prostate tissue.

• GreenLight laser: A high-intensity laser beam is used to vaporise excess tissue.

In addition, medications may be prescribed to reduce lower urinary tract symptoms and reduce the size of the prostate.

Prostate cancer treatment usually involves surgery, radiation therapy and/or hormone therapy¹⁰.

• Surgery may involve complete or partial removal of the prostate gland depending on the stage of the cancer.

• Radiation therapy may be used to shrink tumours before or after surgery.

• Hormone therapy is typically used in advanced stages to slow the growth of prostate cancer cells.

• Targeted therapy is also sometimes used to block the growth of cancer cells.

No matter which prostate condition you have, it's important to consult a doctor for an accurate diagnosis and treatment plan. 

Early detection and treatment for prostate cancer at an early stage greatly can improve outcomes and prognosis significantly. With BPH, prompt medical attention can prevent serious complications from occurring. 

With proper care and management, both BPH and prostate cancer can be treated effectively.