The prostate is a small gland located below the bladder and in front of the rectum. As men age, the prostate often increases in size, a condition known as benign prostatic hyperplasia (BPH) or simply, an enlarged prostate.
By their 60s, nearly half of all men experience symptoms of BPH. By age 70, that number climbs significantly. However, this enlargement is not cancerous, and it does not lead to cancer.
Comparing Symptoms: Enlarged Prostate vs. Prostate Cancer
A critical difference between these two conditions lies in their symptoms—or lack thereof.
Prostate cancer, especially in its early stages, usually causes no symptoms at all. In contrast, BPH often leads to noticeable urinary issues, including:
- Frequent urination
- Urgency to urinate
- Difficulty starting or stopping urine flow
- Getting up multiple times at night
When prostate cancer becomes advanced, it might cause symptoms similar to BPH—such as urinary blockage or discomfort—but by then, the cancer is typically in a late stage.
“Prostate cancer is often silent until it’s quite advanced,” said Dr. Fulgham. “That’s why screening is so important.”
Can an Enlarged Prostate Become Dangerous?
While BPH is not cancerous, it can still affect health if left untreated. In rare cases, it can:
- Prevent the bladder from fully emptying
- Lead to recurring urinary tract infections
- Increase bladder pressure and cause kidney problems over time
However, these complications are uncommon and typically develop only after years without treatment.
Treatment Options for BPH
Most men with an enlarged prostate do not need immediate treatment. Depending on the severity of symptoms, doctors may recommend:
- Watchful waiting – Monitoring mild symptoms over time.
- Medications – Two common types are used:
- Alpha-blockers: Relax the bladder opening.
- 5-alpha-reductase inhibitors: Shrink the prostate size.
- Minimally invasive procedures or surgery – Used when medications don’t help or symptoms worsen significantly.
Who Is at Risk for an Enlarged Prostate?
Age is the biggest risk factor for BPH. Other possible influences include:
Genetics – Men with a father or brother who had BPH are more likely to develop it.
Hormonal changes – Altered testosterone and estrogen levels with age.
Obesity and metabolic syndrome – Associated with increased risk, though a direct link is unclear.
When Should Men Be Screened for Prostate Cancer?
While BPH usually presents symptoms early, prostate cancer often doesn’t. That’s why regular screening is critical, especially for higher-risk individuals.
Dr. Fulgham recommends:
- Annual PSA blood tests starting at age 45
- Starting at age 40 for men with a first-degree relative (father, brother) with prostate cancer
- African American men should also begin screening at age 40, due to a higher risk of early-onset prostate cancer
“For most men, prostate cancer—not BPH—is the condition that poses a greater long-term risk,” said Dr. Fulgham. “Early detection can save lives.”
Practical Takeaways for Men
Don’t confuse BPH with cancer: They’re separate conditions.
Know the symptoms: BPH causes urinary issues; early prostate cancer usually doesn’t.
Screen early if you’re at risk: Family history and race matter.
Talk to your doctor: If you experience urinary problems, don’t ignore them.
Conclusion
Understanding the difference between an enlarged prostate and prostate cancer is vital for men as they age. While both are common, only one poses a serious long-term threat. With routine screening and attention to urinary symptoms, men can take control of their prostate health and detect problems before they become serious.
