BPH or Prostate Cancer? How to Tell the Difference This Prostate Cancer Awareness Month

Home > BPH or Prostate Cancer? How to Tell the Difference This Prostate Cancer Awareness Month

September is Prostate Cancer Awareness Month, making it an important time for men to pay closer attention to their prostate health. Urinary changes such as a weak stream, frequent urination, or getting up several times during the night are often associated with benign prostatic hyperplasia (BPH), a common noncancerous enlargement of the prostate.

Since some symptoms can overlap with prostate cancer, and early prostate cancer may cause no symptoms at all, it is important not to assume that every prostate change is simply part of getting older. Understanding the differences between BPH and prostate cancer can help you recognize when it’s time to talk with a healthcare provider and take a proactive approach to your prostate health.

BPH vs. Prostate Cancer: What's the Difference?

BPH and prostate cancer are two different prostate conditions, but they can sometimes cause similar urinary symptoms. Understanding the difference is important because experiencing urinary changes does not necessarily mean you have prostate cancer. At the same time, urinary symptoms should not automatically be attributed to an enlarged prostate without an appropriate evaluation.

Here are some of the key differences:

Feature	BPH (Enlarged Prostate)	Prostate Cancer
Primary Cause	Non-cancerous tissue growth in the inner prostate zone; common with aging	Uncontrolled growth of abnormal malignant cells, typically starting in the outer zone
Urinary Symptoms	Frequent & Immediate: Weak stream, night waking (nocturia), and urgency caused by urethral squeezing	Silent Early On: Typically zero symptoms in early stages; late stages can mimic BPH symptoms
Prostate Size Impact	Directly linked to gland enlargement; larger volume generally means more blockage	Size does not dictate risk; cancer can develop in normal-sized or minimally enlarged prostates
Co-occurrence	Very Common: Does not transform into cancer, but both conditions frequently exist together	Independent condition; having BPH does not protect against or cause prostate cancer
PSA Elevation	Increases PSA gradually due to overall tissue volume or inflammation	Increases PSA levels; evaluated using PSA Density (PSAD) to separate volume from malignancy

Numerous studies have been done on the association of symptomatic BPH and prostate cancer. In a 2011 randomized controlled trial, results from 5,068 men from the Prostate Cancer Prevention Trial found that symptomatic BPH was not associated with an increased risk of prostate cancer after accounting for factors such as age, race, and BMI. This study is one of the many that supports the important distinction that BPH is not prostate cancer and having symptomatic BPH does not necessarily mean a man is at higher risk of developing prostate cancer.

How Do Doctors Tell the Difference Between BPH and Prostate Cancer?

Since BPH and prostate cancer can cause some of the same symptoms, doctors cannot determine the cause based on urinary symptoms alone. Instead, a urologist looks at several factors, including your symptoms, medical history, risk factors, and test results, to determine whether further evaluation is needed.

Depending on your individual situation, this evaluation may include:

Medical and family history: Your doctor may ask about your urinary symptoms, overall health, family history of prostate cancer, age, and other factors that may influence your risk.
PSA blood test: Prostate-specific antigen (PSA) is a protein produced by the prostate. Higher-than-expected PSA levels can be associated with prostate cancer, but they can also occur with BPH, inflammation, infection, or other prostate conditions. A PSA result is therefore one piece of the overall picture rather than a cancer diagnosis on its own. For instance, a study by European Urology found substantial overlap in PSA levels between men with BPH and men with organ-confined prostate cancer, thus further reinforcing the idea that PSA should be interpreted in context rather than treated as a standalone cancer diagnosis.
Physical examination: Your healthcare provider may perform an examination of the prostate when appropriate as part of your overall evaluation.
Imaging: If there is concern about prostate cancer, your urologist may recommend imaging such as an MRI, which can help identify areas of the prostate that may warrant further investigation.
Prostate biopsy: If testing and imaging suggest that cancer may be present, a biopsy may be recommended. During a biopsy, small samples of prostate tissue are collected and examined under a microscope to determine whether cancer cells are present.

If prostate cancer is diagnosed, additional testing may be used to determine the cancer’s location, grade, and stage. These details are important because prostate cancer is not one-size-fits-all, and treatment recommendations depend on the characteristics of the individual cancer.

Prostate Cancer Treatments Offered at BPH Canada

For men with localized prostate cancer, treatment options may include active surveillance, surgery, radiation therapy, or certain focal treatments, depending on factors such as the cancer’s location and risk level. NanoKnife Focal Therapy, for example, uses irreversible electroporation (IRE) to target and destroy cancerous tissue while aiming to preserve surrounding healthy prostate tissue.

For men undergoing certain prostate cancer treatments, SpaceOAR may also be used to help protect the rectum from radiation exposure. The hydrogel is placed between the prostate and rectum to create additional space, which can help reduce the amount of radiation reaching the rectum during radiation therapy.

Prostate Cancer Awareness Month: Take Charge of Your Prostate Health with BPH Canada

Prostate Cancer Awareness Month is a reminder to take action when it comes to your health. Whether you are experiencing bothersome BPH symptoms, have concerns about your prostate cancer risk, or simply want to be proactive about your health, talking with our world-class urologist can help you understand your options. This Prostate Cancer Awareness Month, make your prostate health a priority by getting informed, understanding your risk, and taking the next step toward personalized care. Book an appointment with us today.