BPH vs Prostate Cancer

Many men are unfamiliar with the state of their prostate or the problems it can encounter. A 2019 survey showed that 1 in 4 men older than 50 knew about the prostate’s primary function. But, they had many misconceptions about prostate health.

Only 38% of respondents correctly identified benign prostatic hyperplasia (BPH). Just 17% of those evaluated correctly stated that enlarged prostate symptoms were not a typical sign of aging. 

These results are worrying since they targeted an age group that is most likely to develop prostate-related disorders, especially enlarged prostate and prostate cancer. Improving awareness of prostate health is a crucial factor for a healthy body. 

That’s why it is vital for men to differentiate and recognize the two conditions. Here, people can take a closer look at these highly prevalent conditions, including their similarities and differences. So, let’s begin. 

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What Is BPH?

When men are young, their prostate is very small. By the time they reach puberty, their testosterone increases, thus the prostate becomes bigger. At the end of puberty, the prostate weighs roughly 20g. But, from 20 years to 50 years of age, the prostate doubles. It keeps growing by the age of 80. 

In certain individuals, the prostate grows quicker than others, causing an enlarged prostate. This is what we call benign prostatic hyperplasia (BPH). Benign means the prostate condition isn’t cancer. Hyperplasia refers to abnormal cell growth. 

According to 2021 reports, BPH prevalence is 50% to 60% in men in their 60s. But, the rates skyrocket as they grow older, reaching a staggering 80% to 90% for those older than 70. A digital rectal exam is an integral component in evaluating patients with presumed benign prostatic hyperplasia. 

BPH, also referred to as benign prostatic hypertrophy, puts a lot of strain on the urinary tract. So, patients need adequate treatment to keep the urinary system in check. For example, for a patient with normal prostate, there is proper urine flow. The urine doesn’t encounter any obstacles and can leave the bladder with ease through the urethra. 

But, when the prostate gland is enlarged, as with BPH, the prostate presses on the urethra and bladder. Therefore, it hinders the flow of urine. The urethra becomes thinner and the bladder has a tough time emptying. Instead, there is a backflow of urine or sometimes a complete block of urine flow, which can profoundly impact the kidneys and bladder. 

Symptoms

The increased prostate gland causes many urinary problems. With an enlarged prostate gland, the BPH symptoms come from the blocked urethra and overworked bladder. 

The urinary pathways can’t function properly, which is why it leads to the following urinary symptoms. 

  • Constant need to urinate at night (nocturia)

  • Urine with unusual smell or color

  • Difficulties starting the urine stream

Together with these symptoms, the condition could trigger a urinary tract infection. But, the size of the prostate gland won’t necessarily influence the severity of the blockage or any symptom. Some patients with highly enlarged prostates experience little urine blockage and fewer symptoms. 

Others with minimal prostate tissue enlargement have bigger blockages and more prostate symptoms. Lower urinary tract symptoms occur in less than 50% of patients with BPH. The condition can also lead to bladder stones

What Is Prostate Cancer?

Prostate cancer is a malignant disease that can impact any section of the prostate. Yet, it typically occurs in the lateral lobes. Advanced cancer travels within the pelvic floor, but cancer could also spread towards the bones. 

The odds of prostate cancer increase with age. Roughly 6 in 10 cases of prostate cancer are diagnosed in male patients older than 65 and rarely in anyone under 40. This cancer is a serious illness.  

Cancer cells are dangerous because they clump together to create tumors. A growing tumor is more than capable of destroying normal cells. It can damage the healthy tissues of the human body, or in this case, the prostate tissue.

Surgery to remove cancer and the prostate could damage the nerves and bladder muscle. Any prostate cancer-related surgery can weaken the support of the bladder. It can also lead to stress incontinence, which puts a lot of pressure on the urinary pathways. 

Then, there is radiation therapy. Other than surgery, radiation can lead to prostate problems and urination difficulties which are quite like BPH. Radiation for cancer could cause changes in the flow of urine. Men may need to urinate countless times during the day or night in abnormal volumes. 

Accompanied by the narrowing of the urethra, trying to urinate can be a difficult process. Lack of voluntary urine control (incontinence) is a typical problem for men after having prostate cancer surgery. 

Although the issue can dissipate in 6 to 12 months, some need additional treatment to regain full bladder control. In these cases, the treatment and surgery for prostate cancer affect their day-to-day life, making it hard to get the urinary pathways back on track.

Symptoms

Prostate cancer won’t always cause obvious signs. That’s until it grows big enough to put pressure on the tube in charge of carrying the urine. When that happens, patients can develop the following prostate cancer symptoms.

  • Weakened flow of urine

  • Taking a long time to pee

  • Trouble emptying the bladder completely

  • Blood in semen/urine

  • Recurrent need to urinate

BPH or Prostate Cancer – How Do I Know What I’m Dealing With?

Both prostate cancer and BPH begin in the prostate. That’s why they have similar symptoms. They are also diagnosed the same way. Either with a PSA test or rectal exam. But, this is their only similarity. BPH emerges in the central component of the prostate gland, whereas cancer grows in the peripheral zone. 

Even though the two typically coexist, BPH is not a risk factor for cancer of the prostate. Old age is the biggest predictor of increased cancer risk, together with family history, research shows. In other words, they don’t trigger one another. 

To manage BPH, doctors recommend medical treatment, mainly with alpha-blockers. If the urinary pathways have suffered significant damage or need a more invasive treatment method, the doctor can suggest surgery like transurethral resection, for example. 

Cancer treatment features active surveillance, radiation, or hormone therapy of the urinary pathways. It can also lead to surgery or cryotherapy. Prostate cancer screening can help assess cancer that could be vulnerable to spreading. A prostatic fluid sample can provide the necessary information. 

Erectile dysfunction could develop post-BPH or cancer treatment. Urinary tract complications caused by BPH are likely to happen. ED prevalence is roughly 50% at 50 years, reaching a whopping 70% at the age of 70 or older.

When it comes to natural treatment methods, saw palmetto for the prostate is a go-to choice. It seems to keep tumor cells from increasing. Therefore, it could be used as a potential treatment method for this type of cancer. 

Conclusion

The urinary tract goes through a lot of changes once it develops BPH or cancer. Especially after surgery. But, to know what you are dealing with, you should know the ins and outs of both prostate problems. Here you can get a detailed insight into the urinary pathway, including the symptoms you can expect, like the after-effect of surgery or any other treatment. That way, patients will have an easier time understanding these highly prevalent prostate health problems. 

Next Up

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Find out 12 Steps To Better Prostate Health.

Sources

  1. Ng M, Baradhi KM. Benign Prostatic Hyperplasia. [Updated 2021 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. https://www.ncbi.nlm.nih.gov/books/NBK558920/
  2. Chang RT, Kirby R, Challacombe BJ. Is there a link between BPH and prostate cancer? Practitioner. 2012. https://pubmed.ncbi.nlm.nih.gov/22792684/
  3. Glina S, Glina FP. Pathogenic mechanisms linking benign prostatic hyperplasia, lower urinary tract symptoms and erectile dysfunction. Ther Adv Urol. 2013. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3721438/
Alternative Text

Dr. Ahmed Zayed

Dr. Ahmed Zayed holds a baccalaureate of Medicine and Surgery. He has completed his degree at the University of Alexandria, Egypt. Founder of ZayedMD, Dr. Ahmed believes in making the knowledge as accessible as possible to patients. He had his work featured in reputable publications such as The Huffington Post. Other than his passion for writing, Dr. Ahmed spends​ his time outside the hospital at the gym or with a good book.

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