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Dr. Samadi: Know the difference between BPH and prostate cancer


How is BPH different from prostate cancer?


For being two entirely different conditions, benign prostatic hyperplasia (BPH) and prostate cancer have a few similarities in common:


Both affect the prostate gland, a walnut-sized gland sitting below a man’s bladder.


Both cause the prostate gland to enlarge causing certain symptoms they share.

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Both conditions are common in men — about one out of every seven men will be diagnosed with prostate cancer, while one out of every two men in their fifties and older will have BPH.


Other than the above similarities, BPH and prostate cancer are quite different.


Understanding BPH


The main difference between BPH and prostate cancer is that even though the prostate gland is enlarged in both, in BPH it is a benign or noncancerous condition. BPH is very common especially as a man ages and his prostate begins to grow. When this happens, it puts pressure on the urethra resulting in the following symptoms:

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  • An urgent need to urinate

  • Having the need to urinate many times during the day and night

  • Hesitancy or troubling starting a urine flow

  • Weak or dribbling urine stream


Prostate cancer can also have the same symptoms as listed above, making it imperative that any man with these symptoms needs a complete physical exam by his doctor to determine what the exact cause is.


During a physical exam, a doctor will be able to tell through a digital rectal exam if the prostate is enlarged. Also, an elevated blood test called prostate specific antigen or PSA, can confirm if it might be BPH.


Having BPH does not cause prostate cancer and unlike prostate cancer, it cannot spread to other areas of the body.

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Treatment options available for BPH fall under medications and minimally-invasive surgical procedures. Which treatment option is best for you depends on the size of your prostate, your symptoms, your overall treatment goals, your age, and your overall health.


If medications are not effective, or your prostate is too large for medication to make a sufficient difference, surgery to reduce the size of the prostate may be necessary.


Understanding prostate cancer


The most common cancer in men, other than skin cancer, is prostate cancer. It is the second leading cause of death from cancer in men and affects more African American males than white men. It is not known what exactly causes it but prostate cancer is due to uncontrolled growth of prostate cancer cells.

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In the early stages, prostate cancer has no symptoms. It is not until it has advanced that symptoms begin to appear, which can include many of the same as BPH but may also include:


  • Painful or burning urination

  • Blood in the urine

  • Erectile dysfunction

  • Painful erection

  • Less fluid during ejaculation

  • Blood in semen


Any changes noticed should be evaluated by a doctor. During the physical exam of the prostate, the doctor may notice it feels nodular or bumpy as well as firm and enlarged. Blood tests will also show a higher PSA and alkaline phosphatase.


Typically, prostate cancer usually grows very slowly and is found more frequently in men older than 65. But the earlier it is diagnosed, the earlier it can be treated to increase the likelihood of survival.

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How prostate cancer is treated depends on how aggressive the cancer is as well as a man’s overall health. Treatment can range from close monitoring called active surveillance, surgery, radiation therapy, hormonal therapy or other options.


Dr. Samadi is a board-certified urologic oncologist trained in open and traditional and laparoscopic surgery and is an expert in robotic prostate surgery. He is chairman of urology, chief of robotic surgery at Lenox Hill Hospital. He is a medical contributor for the Fox News Channel’s Medical A-Team. Follow Dr. Samadi on Twitter, Instagram, Pintrest, SamadiMD.com, davidsamadiwiki, davidsamadibio and Facebook.


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