Prostate Cancer Versus Benign Prostatic Hyperplasia

Introduction:

The prostate gland is situated just below the urinary bladder in men. Its main function is to produce fluid that nourishes sperm (seminal fluid). The cause of abnormal prostate gland function is still being researched. An increase in cancer cells can cause prostate cancer. At the same time, BPH (benign prostatic hyperplasia) is the enlargement of the prostate gland, which can be seen in older adults. Though prostate cancer and BPH affect the prostate gland, BPH is less severe as compared to prostate cancer in some cases.

What Is Prostate Cancer?

The abnormal growth of cancer cells or the spread of cancer from one region to another is called prostate cancer. It usually occurs in older age, obese individuals and people with a family history of prostate cancer. This also affects the individual's reproductive health.

What Are the Signs and Symptoms of Prostate Cancer?

Following are the signs and symptoms of prostate cancer:

• Loss of appetite and weight.

• Paralysis and weakness.

• Renal failure.

• Blockage of urine.

• The active region due to prostate cancer is affected. For example,

1. Anemia and bone pain due to bone involvement.

2. Cough due to lung involvement.

What Is BPH?

BPH stands for Benign prostatic hyperplasia, which affects the prostate gland. It is also called prostate enlargement. It is the most common tumor found in men. It is not a cancer lesion. It causes difficulty in urination, formation of infection, decrease in kidney function, and even bladder stone formation. With the presence of many such symptoms, it still should be noted that it is not a precursor to cancer in that region.

What Are the Causes and Symptoms of BPH?

Benign prostatic hyperplasia is relatively caused due to risk factors such as:

• Old-age.

• Abnormal increase in the size of healthy cells.

There are two reasons for the occurrence of symptoms:

1. Urinary obstruction.

2. Secondary changes in the bladder.

Symptoms followed by urinary obstruction include:-

• Difficulty in urination despite straining.

• Dripping of the urine.

Symptoms followed by secondary changes in the bladder include:-

• Increase in the frequency of urination.

• The feeling of fullness in the bladder.

• Awakening during sleep with an urge to urinate.

What Are the Diagnostic Methods for BPH and Prostate Cancer?

• Medical History - Taking a proper medical history is advised for any prostate cancer case or BPH.

• Digital Rectal Examination - Rectal examination is done and digitally viewed for better diagnosis.

• Urine Analysis - Urine analysis is done to check for any infection.

• Urine Culture - Urine culture is also done, especially to detect the type of organism causing the infection.

• Blood Analysis - The presence of certain components in blood detects the presence of kidney problems.

• Urinary Flow Test - The rate of flow of urine is determined by a machine. Reports of the test help in determining the progress of the condition.

• Transrectal Ultrasound - Complicated conditions are advised with this diagnostic method. A probe ultrasound is placed into the rectum to evaluate the prostate gland. It also helps in guiding instruments to collect tissue for biopsy.

• Cystoscopy - It is a procedure that is done under local anesthesia. A cystoscope is an instrument placed into the urethra, helping in visualizing the internal structure digitally.

Does BPH Cause Prostate Cancer?

Any abnormal change in the anatomy of the organ leads to a change in the functionality of the particular organ. BPH hampers the functions of the prostate gland. Studies have shown that most prostate cancers are seen in individuals with BPH, but it does not prove it to be the cause of prostate cancer. The risk of bladder cancer also increases due to the presence of BPH.

What Are the Treatment Modalities for Prostate Cancer?

Treatment methods for prostate cancer include:

• Hormone Therapy- Androgen deprivation therapy, also called hormonal therapy, is a treatment that follows lowering the levels of male hormones, which reduces the growth of cancer cells.

• Androgen Axis Inhibitor - It is a medication used to treat local and locally advanced prostate cancer. It acts by blocking the growth of cancer cells.

• Chemotherapy - The usage of drugs to destroy cancer cells and prevent the formation of new cells is called chemotherapy.

• Radiation Therapy - High-energy X-rays are used to destroy cancer cells. A common type of radiation therapy is external beam radiation therapy.

• External Beam Radiation Therapy - Hypofractionated radiation therapy is a type of radiation treatment where the patient is exposed to a higher dose of radiation in a short period of time.

• Targeted Therapy - Targeted therapy aims only at cancer-causing proteins or genes. It works by blocking the growth and spread of cancer cells, not causing any harm to the healthy cells.

• Surgery - Surgical removal of the entire prostate gland, along with the removal of pelvic lymph nodes, is done when necessary. Symptoms of the condition are noted and treated accordingly.

There are other minimally invasive surgical procedures that are quite advanced.

What Are the Treatment Modalities for BPH?

The treatment approach depends on the clinical condition of the patient or the severity of symptoms. Usually, treatment is not indicated in patients without major symptoms or symptoms which are not bothersome.

The surgical method of approach is indicated in the following clinical conditions:-

• Bladder emptying issues.

• Stones in the bladder.

• Infected urine.

• Blood in the urine.

Three modes of treatment advised are:

• Watchful Waiting - The treatment for BPH is not started immediately. However, certain precautions are followed during this period to avoid the worsening of the symptoms. Progress is monitored, and the patient is recalled.

• Medications - Following are the types of drugs used to treat BPH:

1. 5- alpha-reductase inhibitors.

2. Alpha-adrenergic blockers.

It is important to keep in mind that not every patient is treated medically. These drugs help in the reduction of the size of the prostate gland as well as a reduction in the signs and symptoms.

• Surgery - Surgical treatment is advised in individuals who are not responding to medical therapy and also in those individuals who are developing additional complications. Following are the surgical procedures used:

1. Monopolar transurethral resection.

2. Bipolar transurethral resection.

3. Prostatectomy (removal of the prostate gland).

Conclusion:

Prostate cancer and BPH show relatively similar effects, but the treatment modalities differ. Early diagnosis of the condition is necessary to obtain better treatment outcomes. Proper monitoring of the patient along with regular medication can help in improving the clinical condition of the patient and in severe cases surgical management is carried out. Consulting a physician and an oncologist is important to achieve better results.