Prostate cancer and benign prostatic hyperplasia (BPH) are both conditions that affect a man’s prostate gland. Some forms of prostate cancer, as well as prostate cancer in its early stages, may present symptoms similar to BPH. Both BPH and prostate cancer may give you trouble with urination. The following symptoms are common to both conditions:
- difficulty with beginning urination
- needing to strain to urinate as the condition progresses
- needing to urinate more frequently
- getting up once or several times a night in order to urinate
- a decreased or weakened urine flow
- urine that comes out in spurts instead of in a steady stream
- leaking or dribbling urine
- a feeling of urine remaining in the bladder even though you have finished urinating
- blood in the urine
These symptoms are a result of the prostate gland enlarging and blocking the flow of urine from the bladder. However, despite these similarities, BPH and prostate cancer are very different diseases.
BPH is not prostate cancer!
The most important thing to remember is that BPH and prostate cancer are not linked to each other. BPH does not cause prostate cancer nor does it eventually turn into prostate cancer. It does not increase your risk of developing this life-threatening disease in the future.
However, since BPH and prostate cancer can present the same symptoms, your doctor may run a number of tests in order to determine what exactly is affecting your prostate. It is important for your doctor to know what is causing your symptoms, since there are conditions aside from BPH and prostate cancer that can cause problems with urination. BPH and prostate cancer also differ in terms of how they are treated and how severely they can affect your health. Your doctor may recommend the following tests or procedures:
Digital rectal exam (DRE)
This is usually the first procedure your doctor will perform if you come in with symptoms related to urination and the prostate. In this exam, your doctor will insert a gloved finger into your rectum. Lubrication will be applied to minimize the pain and discomfort of the procedure. Your doctor will then feel, or palpate, your prostate from within your rectum. With DRE, your doctor can feel if your prostate is enlarged or irregularly shaped. Normally, your prostate should feel smooth and firm, but not rigid. With BPH, the prostate still retains its normal texture even if it is enlarged. If your prostate is irregularly shaped, rough to the touch, has bumps, or is very hard, prostate cancer is more likely. Your doctor may request additional tests to confirm the presence of prostate cancer.
Prostate specific antigen (PSA) level
This blood test measures the amount of PSA, which is a protein produced by your prostate. The larger a prostate gland is, the more PSA is produced. Infection of the prostate, as well as BPH, may cause your PSA level to increase. However, a very high or rapid increase of PSA may signify prostate cancer.
Biopsy
If other tests indicate that prostate cancer is more likely to be the one causing your symptoms than BPH, a biopsy will confirm this. This is usually the last test done. In a biopsy, your doctor surgically removes a part of your prostate. This tissue sample from your prostate is examined under a microscope to see if cancer cells are present. Aside from confirming if you have prostate cancer, a biopsy can be used by your doctor to stage your prostate cancer. The information from your biopsy can tell your doctor which treatment will be best for you.
BPH and prostate cancer – enlarging the prostate in different ways
BPH is an enlargement of the prostate gland that happens as a man grows older. This enlargement occurs because the cells inside the prostate gland increase in number. However, the cells that multiply when you have BPH are still normal prostate gland cells. These cells cause the prostate to grow inwardly. They are not aggressive or dangerous cells, and they do not grow outside the prostate gland itself.
In contrast, prostate cancer causes your prostate gland to enlarge because of a tumor. This tumor is a collection of abnormal cells that grow very rapidly. Prostate cancer can make your prostate expand in an irregular fashion. One or more tumors can grow inside your prostate, causing the shape and texture of your prostate to change. This is why a prostate that is affected by cancer is likely to be irregularly shaped and abnormal in texture.
Cancer cells may also spread from the prostate and go to other parts of the body, causing disease elsewhere. This ability of cancer cells to spread is called metastasis. Prostate cancer often metastasizes to nearby bones, especially the bones found in your lower back. This can cause very severe low back pain as the disease progresses.
Prostate cancer – a more severe disease requiring more aggressive treatment
If BPH is the cause of your symptoms, medications to relieve your symptoms may often be enough. If you have very severe problems related to urination, your doctor may recommend surgery to reduce the size of your prostate and relieve the pressure on your urethra and bladder. However, BPH is not a fatal condition.
Prostate cancer, on the other hand, can cause symptoms other than urinary problems. You may have problems with sexual function. If the cancer metastasizes, your bones, bladder, and other organs may be affected. Aggressive prostate cancer can be fatal. You may need surgery to remove the tumor, or your entire prostate may need to be removed. You may also need further treatment such as radiotherapy or hormonal therapy even after surgery.