Benign Prostatic Hyperplasia and Prostate Cancer

The prostate gland is a small, almond-shaped gland located just below the bladder in men. It is an important part of the male reproductive system and is responsible for producing a fluid that helps transport sperm. The prostate gland is surrounded by the urethra, the tube that carries urine and semen out of the body. As men age, the prostate gland can enlarge, causing problems with urinary symptoms. This can be due to either benign prostatic hyperplasia (BPH) or prostate cancer. 

 

Benign Prostatic Hyperplasia (BPH): BPH is a condition where the prostate gland enlarges as men age. The growth of the prostate gland can put pressure on the urethra, causing urinary symptoms. BPH is a common condition affecting around 50% of men over the age of 50 and up to 90% of men over the age of 80. 

Causes of BPH

The exact cause of BPH is unknown, but several factors are thought to play a role. As men age, hormonal changes can cause the prostate gland to enlarge. Additionally, genetics may also be a factor as BPH tends to run in families. 

Symptoms of BPH: BPH can cause several urinary symptoms, including:

  • Frequent urination, especially at night 
  • Weak urine stream 
  • Difficulty starting and stopping urination 
  • Urinary incontinence 

It is important to note that these symptoms can also be caused by other conditions, such as urinary tract infections or prostate cancer, so a proper diagnosis by a doctor is necessary for appropriate treatment. 

Treatment for BPH

The treatment for BPH depends on the severity of the symptoms and can range from lifestyle changes to medical and surgical treatments. 

  • Lifestyle changes can include: 
  • Limiting fluid intake before bedtime 
  • Avoiding drinks that can irritate the bladder, such as caffeine or alcohol 
  • Scheduling regular bathroom breaks during the day 
  • Practicing pelvic muscle exercises to strengthen the muscles that control urination 

Medical treatments for BPH include:

  • Alpha-blockers: These medications relax the muscles in the prostate and bladder, making it easier to urinate. 
  • 5-alpha reductase inhibitors: These medications slow the growth of the prostate, reducing symptoms and improving urinary flow. 
  • In more severe cases, surgical options such as transurethral resection of the prostate (TURP) or laser therapy may be recommended. TURP is a surgical procedure that removes part of the prostate gland through the urethra. Laser therapy uses a laser to vaporize part of the prostate gland. 

Prostate Cancer

Prostate cancer is a condition where abnormal cells grow in the prostate gland and form a tumour. Prostate cancer is the second most common cancer in men, after skin cancer. The risk of prostate cancer increases with age and it is estimated that 1 in 9 men will be diagnosed with prostate cancer in their lifetime. 

Causes of Prostate Cancer

The exact cause of prostate cancer is unknown, but several risk factors have been identified, including: 

  • Age: The risk of prostate cancer increases as men age. 
  • Family history: Men with a family history of prostate cancer are at higher risk. 
  • Certain genetic mutations: Some men have genetic mutations that increase their risk of prostate cancer. 

Symptoms of Prostate Cancer

In its early stages, prostate cancer may not cause any symptoms. However, as the cancer grows, symptoms may include: 

  • Difficulty urinating 
  • Pain during urination 
  • Blood in the semen or urine 
  • Weak or interrupted urine stream 
  • Pain or stiffness in the lower back, hips or upper thighs 

It is important to note that these symptoms can also be caused by other conditions, such as BPH or a urinary tract infection, so a proper diagnosis by a doctor is necessary for appropriate treatment. 

Diagnosis of Prostate Cancer

Diagnosing prostate cancer often involves a combination of tests, including: 

  • Physical exam: The doctor will feel the prostate gland for any unusual lumps or bumps. 
  • PSA test: A blood test that measures the level of prostate-specific antigen (PSA) in the blood. High levels of PSA can be a sign of prostate cancer. 
  • Biopsy: A sample of tissue from the prostate is taken and examined under a microscope for cancer cells. 

Treatment for Prostate Cancer

The treatment for prostate cancer depends on the stage and aggressiveness of the cancer and can range from active surveillance to surgery or radiation therapy. 

  • Active surveillance is an option for men with early stage, low-risk prostate cancer. This involves regular check-ups and monitoring of the cancer to ensure it is not growing or spreading. 
  • Surgery, such as a radical prostatectomy, involves removing the entire prostate gland and surrounding tissue. This is usually recommended for men with early stage, high-risk prostate cancer. 
  • Radiation therapy uses high-energy beams, such as X-rays or protons, to kill cancer cells. This can be delivered externally (external beam radiation therapy) or internally (brachytherapy). Radiation therapy may be recommended for men with early or advanced stage prostate cancer. 
  • Hormonal therapy is another treatment option for prostate cancer. This involves reducing the amount of testosterone in the body, as testosterone can fuel the growth of prostate cancer cells. Hormonal therapy can be delivered through medication, such as androgen deprivation therapy (ADT), or through surgical removal of the testicles (orchiectomy). 
  • Chemotherapy is a treatment option for men with advanced stage prostate cancer that has spread beyond the prostate gland. This involves using drugs to kill cancer cells. 
  • Finally, new and innovative treatments, such as immunotherapy and targeted therapy, are being developed and studied as potential options for the treatment of prostate cancer. These treatments work by boosting the body’s immune system to attack the cancer cells or targeting specific proteins or genes that drive the growth of the cancer. 

In conclusion, both BPH and prostate cancer are common conditions affecting men as they age. While BPH can be managed with lifestyle changes and medications, prostate cancer requires prompt and appropriate treatment to ensure the best outcomes. Regular check-ups and screening, such as a PSA test, are important for early detection and management of both BPH and prostate cancer 

 

About The Author

Dr. Krisca is a highly-educated and skilled physician who has obtained a BS Public Health degree from the University of the Philippines Manila and a Doctor of Medicine degree from the De La Salle Medical Health Sciences Institute. She is a licensed physician and also a Registered Medical Technologist. She has received additional training in Hemodialysis for Non-Nephro Physicians on duty and has completed online courses in related fields like depression in populations from John Hopkins University and positive psychiatry from The University of Sydney. Currently, she is pursuing a Master of International Health in the University of the Philippines. 

 

Dr. Krisca is known for her outstanding skills and compassionate approach to healthcare that make a positive impact on people’s lives. Through her passion for healthcare, she hopes to make a difference in the world and help people lead healthier, happier lives. 

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