What are the differences between BPH and prostate cancer?

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BPH causes enlargement of the prostate. The term “benign” means it is not cancerous, while “hyperplasia” describes the abnormal growth of the prostate cells.

Conversely, prostate cancer causes cancer cells to grow in the prostate tissue. These cells grow in an uncontrolled manner. Prostate cancer is a relatively slow-growing cancer, which means it may not cause any symptoms for several months or years.

BPH and prostate cancer are two distinct conditions that do not typically share common symptoms. While BPH frequently causes symptoms, prostate cancer is often asymptomatic.

Symptoms of BPH include:

• trouble starting the flow of urine or producing more than a dribble
• passing urine often, especially at night
• feeling that the bladder has not fully emptied
• a strong or sudden urge to pass urine
• weak or slow urine stream
• stopping and starting several times again while passing urine
• pushing or straining to pass urine

Additionally, severe cases of BPH can cause bladder and kidney problems.

Because prostate cancer is slow-growing, it typically shows no early symptoms. In advanced prostate cancer, which is very rare, people may experience symptoms including:

• difficulty passing urine
• frequent urge to pass urine, especially at night
• weak or interrupted urine flow
• pain or burning when passing urine
• blood in the urine or semen
• pain when ejaculating
• pain in the back, hips, or pelvis

If prostate cancer spreads to other body parts, it usually spreads to the bones, especially the spine. Back pain, and sometimes pain in other bones, is a possible symptom of advanced prostate cancer.

To diagnose a prostate condition, a doctor discusses a person’s symptoms and medical history with them. They may also perform one or more of the following tests.

Digital rectal exam (DRE)

This is a standard test that healthcare professionals use to diagnose prostate conditions. They will wear gloves and use lubrication to place a finger in the person’s rectum and examine the prostate for around a few seconds.

During this exam, they will check for the following:

• size, firmness, and texture
• hard areas, lumps, or growths
• pain on touching or pressing the prostate

Prostate-specific antigen (PSA) test

Additionally, doctors use the PSA test to help determine if a person may have prostate cancer.

This test checks levels of total PSA, a protein that helps to make semen. People with prostate cancer have more PSA in their blood than doctors consider normal.

Other prostate checks

If a healthcare professional suspects prostate cancer, they may order a prostate biopsy. This involves taking small tissue samples from the prostate to check for abnormal cells.

Some people may also undergo an MRI scan to check for prostate cancer.

Risk factors for BPH include:

• Age: those aged 40 years and older
• Family history: having a family member who has or had BPH
• Health status: living with overweight, obesity, or erectile dysfunction
• Lifestyle: lower levels of physical activity

According to the American Cancer Society, risk factors for prostate cancer include:

• Age: those aged 50 years old or over
• Race: ACS says African-American individuals have a higher chance of developing prostate cancer at a younger age, followed by white people, then Hispanic and Native American individuals
• Family history: having a father or brother who has had prostate cancer increases a person’s risk two to threefold; having three immediate family members with prostate cancer increases a person’s risk by about 10 times
• Diet: high fat diet

Some people with BPH might opt to manage their condition through watchful waiting. This involves having annual checkups and only starting treatment if symptoms become problematic.

Other options for treating BPH include:

• drug therapy, such as alpha-blockers to relax muscles around the prostate or 5 alpha-reductase inhibitors to shrink the prostate
• surgery, such as TURP (transurethral resection of the prostate), in which a surgeon passes an instrument through the urethra and trims away excess prostate tissue
• lifestyle changes
• natural remedies

Treatment for prostate cancer depends on a range of factors, including:

• the type and size of the cancer
• how advanced the cancer is
• the person’s general health
• whether cancer has spread outside of the prostate

If a person is older and the cancer is unlikely to affect their natural lifespan, they may opt for active surveillance. Other options include:

• surgery
• radiation therapy
• hormone therapy to control prostate cell growth
• high intensity-focused ultrasound (HIFU), which uses sound waves to kill prostate cancer cells with heat
• cryotherapy, or freezing cancer cells to kill them
• chemotherapy

BPH and prostate cancer are two distinct conditions affecting the prostate. Although they share similar risk factors, such as being over 50 and having a family history, they present with different symptoms, and doctors diagnose them with different tests.

With treatment, the outlook for both conditions is positive.