Don't Panic: An Enlarged Prostate Is Probably Not Cancer

The prostate gland plays a role in sexual function in men. This walnut-sized, muscular gland produces secretions that mix with seminal fluid from the seminal vesicles, and it contracts to pump ejaculate out of the penis.

Since the prostate surrounds the urethra where the bladder empties into it, when the prostate is swollen, it can pinch the urethra partially or entirely closed and hinder a man's ability to urinate. This swelling can be the result of a number of conditions, including urinary tract infection (UTI), inflammation of the prostate or narrowing of the urethra.

However, two of the most common causes of an enlarged prostate are benign prostatic hyperplasia (BPH) and prostate cancer. We'll clarify each condition and the differences between the two, so you can understand what they might mean for you.

Before we dive in further, we must note: It's important to understand that most of the time a patient has obstructive urinary symptoms, it is from a large prostate. In the era of PSA-based (prostate-specific antigen) prostate cancer screening, it is quite rare for prostate cancer to be diagnosed from urinary symptoms. Don't overreact, but don't ignore them, either.

What are prostate cancer and BPH?

Like all forms of cancer, prostate cancer is caused by abnormal cells that multiply out of control—in this case, in the prostate, which is below the bladder and in front of the rectum. Prostate cancer is common, affecting about 1 in 8 men, with about 60 percent of diagnoses in men over 64 years old. Often slow-growing, it is highly treatable, though it's critical to detect it early.

BPH is a noncancerous enlargement of the prostate. It is a benign—if annoying—condition and affects about half of men between the ages of 51 and 60, and upward of 90 percent of men older than 80. 

Symptoms of both BPH & prostate cancer

While the conditions have vastly different implications, benign prostatic hyperplasia and prostate cancer often present with similar symptoms, such as the following:

• Urgent need to urinate

• Frequent need to urinate multiple times during the night

• Difficulty starting your stream

• Weak or dribbling urine stream

• Never feeling as if your bladder is empty

• Urine flow that starts and stops

Two other symptoms, blood in your semen and pain during urination, may seem scary. However, blood in semen is a benign condition and not related to prostate cancer, and painful urination is highly unlikely to be tied to cancer. Some symptoms to watch out for that are more closely related specifically to prostate cancer include bone pain, losing weight without trying and erectile dysfunction (ED).

If you experience any of the symptoms more closely tied to prostate cancer, see your doctor right away. Your medical team will perform a series of tests to understand the extent of prostate enlargement and to screen for cancer and other conditions. A BPH diagnosis will lead to treatment with a focus on relieving symptoms. A prostate cancer diagnosis will lead to treatments that vary depending on the aggressiveness of the cancer and your overall health.

It's important to note that researchers don't believe benign prostatic hyperplasia is a cause of prostate cancer, nor is it thought to be a risk factor. It is possible, however, to have both conditions at once.

If you are 50 or older, the American Cancer Society recommends you begin talking to your doctor about regular prostate cancer screenings. That age drops to 45 for men in higher-risk categories, such as Black men and men who have a first-degree relative (father or brother) diagnosed with prostate cancer at an early age (younger than 65), and to age 40 for men with more than one first-degree relative who had prostate cancer at an early age.

Take care of your prostate, and it will take care of you, helping you to enjoy a fulfilling sex life for years to come.