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Is There a Link Between BPH and Prostate Cancer?

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Over 50% of men over the age of 50 and 90% of men over 80 struggle with a swollen prostate. The most common symptoms of this condition involve urination issues, as the walnut-sized gland squeezes the urethra and impedes the flow of urine. This inflammation results in frequent urges, delayed urination, a weak or dribbling stream, and urine flow that stops and starts.

While these symptoms are inconvenient, uncomfortable, and even painful at times, the most likely cause is one of two typically non-threatening conditions: benign prostatic hyperplasia, also known as BPH, or prostatitis. Both conditions cause swelling in the prostate, but the source of the inflammation is different for each condition. BPH involves gradual enlargement of the prostate over time as a natural consequence of aging and often does not involve serious complications. Prostatitis is a more acute condition in which prostate inflammation is caused by a bacterial infection.

However, a third source of prostate inflammation, though less likely, can remain a possibility: prostate cancer. Nearly 1 in 7 men will be diagnosed with prostate cancer at some point in their lives. And despite the public focus on fundraising efforts to cure breast cancer, which affects 1 in 8 women, prostate cancer is even more common.

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Since BPH, prostatitis, and prostate cancer all involve prostate inflammation, the three conditions share many symptoms related to urination. That being said, prostate cancer often manifests in more severe symptoms, which can include any or all of the following:

  • painful or burning urination
  • blood in urine
  • erectile dysfunction
  • painful ejaculation
  • less seminal fluid during ejaculation
  • blood in semen

BPH naturally develops as men grow older, when their bodies are less able to defend against inflammatory free radicals. Similarly, in advanced years, we become more vulnerable to prostate infections, especially in the wake of a urinary tract infection. On the other hand, prostate cancer is caused by a deterioration of DNA at the cellular level. During the natural process of cell death and replacement, also known as apoptosis, older cells die off in order to be replaced by new, healthier cells. However, as a result of genetic or environmental factors, cells can sometimes develop mutations which block the process of apoptosis. This allows older, unhealthy cells to continue to grow unabated, the foundation of a cancerous tumor.

Fortunately, since BPH, prostatitis, and prostate cancer all have separate causes, there is no direct link between the two conditions. Therefore, if you notice a weak, dribbling stream on your next visit to the bathroom, do not panic. Slower urine flow it does not necessarily mean you have prostate cancer or that you are at a greater risk for developing prostate cancer. However, it is often best to consult a physician to rule out the possibility.

Paul

Paul has been interested in medical research since his first organic chemistry class in college. He was a high school biology teacher for 32 years until retiring to spend more time reading, hiking, and camping with his wife and two dogs.

References

  1. Chang RT, Kirby R, Challacombe BJ. Is there a link between BPH and prostate cancer? Practitioner. 2012 Apr;256(1750):13-6, 2. PMID: 22792684.
  2. Schenk JM, Kristal AR, Arnold KB, Tangen CM, Neuhouser ML, Lin DW, White E, Thompson IM. Association of symptomatic benign prostatic hyperplasia and prostate cancer: results from the prostate cancer prevention trial. Am J Epidemiol. 2011 Jun 15;173(12):1419-28. doi: 10.1093/aje/kwq493. Epub 2011 May 3. Erratum in: Am J Epidemiol. 2011 Dec 15;174(12):1425. PMID: 21540324; PMCID: PMC3276227.
  3. McNally CJ, Ruddock MW, Moore T, McKenna DJ. Biomarkers That Differentiate Benign Prostatic Hyperplasia from Prostate Cancer: A Literature Review. Cancer Manag Res. 2020 Jul 1;12:5225-5241. doi: 10.2147/CMAR.S250829. PMID: 32669872; PMCID: PMC7335899.