If you’re a man over 50, you’ve probably heard about the importance of keeping tabs on your prostate health. But for many men, there’s confusion—and fear—around the two most common prostate conditions: benign prostatic hyperplasia (BPH) and prostate cancer.
Both conditions affect the prostate, a small gland just below the bladder that helps produce semen. But while one is a non-cancerous growth that’s common with aging, the other is a potentially life-threatening disease. Understanding the difference can help you take control of your health, avoid unnecessary worry, and recognize when to seek medical attention.
What Is the Prostate, and Why Does It Matter?
The prostate gland is about the size of a walnut in younger men, but it tends to grow larger with age. Located just below the bladder and in front of the rectum, it surrounds the urethra—the tube that carries urine from the bladder out of the body.
As the prostate enlarges, it can press on the urethra and affect urination. But this doesn’t necessarily mean cancer. That’s where the distinction between BPH and prostate cancer becomes critical.
What Is Benign Prostatic Hyperplasia (BPH)?
BPH is a non-cancerous enlargement of the prostate gland. It is incredibly common: by age 60, more than half of men have BPH; by age 85, that number rises to 90%.
Symptoms of BPH include:
- Frequent urination, especially at night (nocturia)
- Difficulty starting urination
- Weak or interrupted urine stream
- Feeling of incomplete bladder emptying
- Urgency or dribbling after urination
While BPH can be frustrating, it’s not life-threatening. However, it can significantly affect your quality of life if left untreated.
What Is Prostate Cancer?
Prostate cancer occurs when abnormal cells in the prostate grow uncontrollably. It’s one of the most common cancers among men in the United States—but unlike many other cancers, it often grows slowly and may not cause symptoms in its early stages.
When symptoms do appear, they may include:
- Trouble urinating (similar to BPH symptoms)
- Blood in urine or semen
- Pain in the hips, back, or pelvis
- Erectile dysfunction
- Unexplained weight loss or fatigue (in advanced stages)
Not every prostate cancer requires immediate treatment, but identifying it early can provide more options and better outcomes.
Key Differences Between BPH and Prostate Cancer
| Feature | BPH (Benign) | Prostate Cancer |
| Growth Pattern | Non-cancerous, centered around the urethra | Malignant, may occur on the outer part of prostate |
| Speed of Growth | Slow and predictable | Varies—can be slow or aggressive |
| Symptoms | Urinary issues (common) | May have no symptoms early |
| Risk to Health | Usually not serious | Can spread and become life-threatening |
| PSA Levels | May be elevated | Often elevated, but not always |
| Treatment Need | Often lifestyle/drugs/surgery if severe | Depends on stage; may include surgery, radiation |
Because both BPH and prostate cancer can cause similar urinary symptoms, the only way to differentiate them is through screening and diagnostic testing.
How Are These Conditions Diagnosed?
If you have symptoms or are over age 50, your doctor may recommend:
1. PSA Blood Test
- The Prostate-Specific Antigen (PSA) is a protein produced by the prostate.
- Elevated PSA can indicate BPH, prostate cancer, or even infection.
- A rising PSA over time is more concerning than a one-time high result.
2. Digital Rectal Exam (DRE)
- A doctor feels the prostate through the rectum to check for size, shape, and irregularities.
- Cancerous prostates may feel hard or lumpy, while BPH usually feels smooth but enlarged.
3. Imaging and Biopsy
- If PSA and DRE raise concern, you may need an MRI or prostate biopsy to confirm or rule out cancer.
How Are They Treated?
BPH Treatment Options:
- Lifestyle changes: Reducing caffeine and alcohol, managing fluids.
- Medications: Alpha-blockers (e.g., tamsulosin), 5-alpha-reductase inhibitors.
- Minimally invasive procedures: UroLift, Rezūm, or laser therapy.
- Surgery: TURP (Transurethral Resection of the Prostate) for severe cases.
Prostate Cancer Treatment Options:
- Active surveillance: For slow-growing cancers.
- Surgery: Prostatectomy (removal of the prostate).
- Radiation therapy: External beam or brachytherapy.
- Hormone therapy: To slow growth.
- Chemotherapy or immunotherapy: In advanced cases.
Your treatment will depend on age, health, stage of cancer, and personal preferences.
When to See a Urologist
You should consult a urologist if you:
- Are over 50 and haven’t had a prostate check
- Experience frequent or weak urination
- Have a family history of prostate cancer
- Notice blood in your urine or semen
- Have elevated PSA or abnormal DRE results
Early detection is key. Whether it’s BPH or prostate cancer, knowledge is power—and so is early intervention.
Final Thoughts
It’s easy to confuse BPH with prostate cancer—especially when the symptoms overlap. But while one is an inconvenience, the other can be life-altering. The only way to know for sure is through proper evaluation by a urologist.
Don’t let fear or misinformation stop you from taking care of your health. Whether you’re dealing with urinary symptoms or just staying proactive, a urologist can guide you through diagnosis, treatment, and peace of mind. We recommend urologist brooklyn.
