Is It BPH or Prostate Cancer?

Skeletal diagram showing a highlighted prostate

Patients often worry about the possibility of prostate cancer when they experience lower urinary tract symptoms, like urinary frequency, urge to urinate, or an inability to fully empty the bladder. These concerns are legitimate, but many patients’ minds go directly to the worst-case scenario they can think of – cancer. However, it is essential to understand the differences between benign prostate issues, like BPH, and something insidious, like prostate cancer.

First, the patient should understand that prostate cancer rarely presents with symptoms, especially in the earliest stages. Therefore, if you are experiencing some or all the symptoms above, chances are it is related to an enlarged prostate and not cancer. This is not to say that a trip to a urologist is not warranted—quite the opposite. Visiting your urologist at this point is essential as we can help eliminate the symptoms associated with BPH and improve your quality of life and lifestyle. Remember that BPH is a progressive disorder and purported remedies such as saw palmetto have no proven benefit. On the flip side, minimally invasive BPH therapies like Rezum, which uses water vapor to ablate or destroy excess prostatic tissue, are convenient and very effective for upwards of five years from the procedure day.

What Is Your PSA Trend?

The 1970s and 80s ushered in a new era of prostate cancer detection. Researchers have found that the prostate secretes a unique chemical compound called prostate-specific antigen or PSA. When this reading was elevated, the risk for prostate cancer increased. While there was a time when every significant rise in PSA (usually above 4) was biopsied, and most cases of prostate cancer were treated, this led to unnecessary surgeries that ultimately cost many patients their continence and erectile function.

We later realize that PSA trending is far more critical in diagnosing prostate cancer than a single reading. Several factors, including age, race, and even a particularly overachieving prostate can lead to elevated PSA reading. Further, if prostate cancer is found, it can be very slow growing, and some patients will never need treatment, simply working with their urologist to monitor and document progression.

This is not to say we shouldn’t be thinking about prostate cancer as we age. It is one of the leading cancer killers in the United States. However, understanding the options and working with a qualified urologist like Dr. Kapadia is critical to know if it requires treatment or should simply be watched for progression.

Today, the PSA has gone from one of the most maligned to arguably the most accurate cancer screening tests in all medicine.

The Bottom Line

If you are experiencing significant urinary symptoms that are interfering with your life, causing you not to interact in certain social situations for fear of a urinary problem, or keeping you up at night, we encourage you to speak to your urologist about options. While traditionally, BPH required surgical intervention, today, BPH patients have more options than ever before, including in-office treatments that do not require general anesthesia and last around 10-to-15 minutes.

We also encourage you to learn more about prostate cancer and PSA screening from your urologist to understand if prostate cancer screening is appropriate and to weigh family history of cancer and other risk factors.

For lower urinary tract symptoms, we encourage you to make an appointment for a consultation. Otherwise, we encourage you to schedule an appointment with Dr. Kapadia to discuss your concerns.