Prostate Cancer: Enlarged Prostate
Benign (noncancerous) enlargement of the prostate, known as benign prostatic hyperplasia (BPH for short), is the most common prostate problem in men. Almost all men will develop some enlargement of the prostate as they age.
When Does Prostate Enlargement Happen?
Overall, the number of men with BPH increases progressively with age. By age 60, 50% of men will have some signs of BPH. By age 85, 90% of men will have signs of the condition. About one third of these men will develop symptoms that require treatment.
Does BPH Increase Your Risk of Developing Prostate Cancer?
Based on research to date, the answer is no. However, BPH and prostate cancer have similar symptoms, and a man who has BPH may have undetected cancer at the same time.
To help detect prostate cancer in its early stages, the American Cancer Society advises annual screening starting at age 50 in men who have at least a 10-year life expectancy. They also say that for men who are at high risk, such as African-American men and men with a family history of prostate cancer, screening should begin at about age 45. Men at an even higher risk, such as having several relatives with a history of prostate cancer at an early age, could begin testing at age 40.
The American Urological Association agrees that annual screening should begin at age 50 but encourages men in high risk groups, such as African-Americans or those with a family history, to begin screening at age 40 as opposed to 45. Tests used to screen for prostate cancer include a blood test for a substance called prostate-specific antigen (PSA) and the digital rectal exam (DRE).
What Are the Symptoms of BPH?
Since the prostate gland surrounds the urethra, the tube that carries urine out of the body, it is easy to see that enlargement of the prostate can lead to blockage of the tube. You may develop:
- Slowness or dribbling of your urinary stream
- Hesitancy or difficulty starting to urinate
- Frequent urination
- Feeling of urgency or sudden need to urinate
- Need to get up at night to urinate
As symptoms progress, you may develop:
- Bladder stones
- Bladder infection
- Blood in your urine
- Damage to your kidneys from back pressure caused by retaining large amounts of extra urine in the bladder
- Sudden blockage of the urinary tube, making urination impossible
How Is BPH Diagnosed?
After evaluating your medical history and giving you a complete physical, your doctor will perform a digital rectal examination.
Because the prostate gland is in front of the rectum, the doctor can feel if the back of the gland has any abnormalities during this examination. This enables the doctor to estimate the size of the prostate and to detect any hard areas that could be cancer.
Several studies may be done to help diagnose your condition:
- A urine test called a urinalysis
- A seven-question BPH Symptom Score Index survey to evaluate the severity of your symptoms
- A flow study to measure how slow the urinary stream is compared with normal flow
- A study to detect how much urine is left in the bladder after urination is done