Prostate Cancer and Benign Prostatic Hyperplasia (BPH)
This module covers two common conditions affecting the prostate gland: Benign Prostatic Hyperplasia (BPH) and Prostate Cancer. Understanding their differences, symptoms, diagnosis, and management is crucial for PLAB 1 preparation.
Benign Prostatic Hyperplasia (BPH)
BPH is a non-cancerous enlargement of the prostate gland. It is extremely common in older men and can lead to lower urinary tract symptoms (LUTS).
Symptoms of BPH
LUTS associated with BPH can significantly impact quality of life. It's important to differentiate these from symptoms of other conditions.
| Symptom Category | Description | Examples |
|---|---|---|
| Obstructive Symptoms | Difficulty in emptying the bladder. | Hesitancy, weak stream, intermittency, straining, incomplete emptying. |
| Irritative Symptoms | Related to bladder storage and bladder irritation. | Frequency, urgency, nocturia (waking up at night to urinate), urge incontinence. |
Diagnosis and Management of BPH
Diagnosis involves a combination of patient history, physical examination, and investigations. Management ranges from watchful waiting to medical and surgical interventions.
Prostate Cancer
Prostate cancer is a malignant tumor that develops in the prostate gland. It is one of the most common cancers in men worldwide.
Symptoms of Prostate Cancer
In its early stages, prostate cancer is often asymptomatic. When symptoms do appear, they can be similar to BPH.
Symptoms may include:
- Difficulty starting urination
- Weak or interrupted urine flow
- Frequent urination, especially at night
- Difficulty emptying the bladder completely
- Pain or burning during urination
- Blood in the urine or semen
- Pain in the back, hips, or pelvis
It is crucial to remember that these symptoms are not exclusive to prostate cancer and can be caused by BPH or other conditions. Therefore, any persistent urinary symptoms warrant medical evaluation.
Diagnosis and Management of Prostate Cancer
Diagnosis relies on screening, PSA testing, DRE, and biopsy. Treatment depends on the stage and grade of the cancer.
Diagnosis of prostate cancer involves a multi-faceted approach. Screening typically includes a Prostate-Specific Antigen (PSA) blood test, which measures the level of PSA produced by the prostate gland. Elevated PSA levels can indicate prostate cancer, but also BPH or prostatitis. A Digital Rectal Examination (DRE) allows a clinician to feel the prostate for abnormalities. If screening tests are suspicious, a prostate biopsy is performed. This involves taking small tissue samples from the prostate using a needle, which are then examined under a microscope by a pathologist to confirm the presence of cancer and determine its grade (Gleason score). The Gleason score is a key factor in determining the aggressiveness of the cancer. Staging investigations, such as MRI or CT scans, may be used to determine if the cancer has spread beyond the prostate.
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Management options for prostate cancer are diverse and depend on the stage, grade, and aggressiveness of the cancer, as well as the patient's overall health and preferences. These include:
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- Active Surveillance: For slow-growing cancers, monitoring with regular PSA tests and biopsies.
- Surgery: Radical prostatectomy (removal of the prostate gland).
- Radiation Therapy: Using high-energy rays to kill cancer cells.
- Hormone Therapy: Reducing male hormone levels (androgens) that fuel prostate cancer growth.
- Chemotherapy: Used for advanced or aggressive cancers.
Key Differences and Overlap
It's crucial to distinguish between BPH and prostate cancer, although they can coexist and share similar symptoms.
| Feature | Benign Prostatic Hyperplasia (BPH) | Prostate Cancer |
|---|---|---|
| Nature | Non-cancerous enlargement | Malignant tumor |
| Cause | Age-related hormonal changes | Uncontrolled cell growth (exact cause unknown) |
| Progression | Gradual enlargement, can cause LUTS | Can be slow-growing or aggressive; can metastasize |
| Symptoms | Primarily LUTS (obstructive and irritative) | Often asymptomatic early; LUTS may occur; bone pain in advanced stages |
| Diagnosis | DRE, PSA (can be elevated), urine tests | DRE, PSA (often elevated), biopsy (definitive) |
| Treatment Goal | Relieve LUTS, improve quality of life | Cure (if early), control growth, manage symptoms, prolong life |
BPH is a non-cancerous enlargement of the prostate, while prostate cancer is a malignant tumor.
A prostate biopsy.
Yes, both can cause lower urinary tract symptoms (LUTS).
Learning Resources
Provides a comprehensive overview of BPH, including causes, symptoms, diagnosis, and treatment options from a trusted UK health authority.
An authoritative guide to prostate cancer, covering risk factors, symptoms, screening, diagnosis, and treatment from the UK's National Health Service.
Detailed information on prostate cancer, including statistics, causes, symptoms, diagnosis, and the latest research from a leading cancer charity.
A thorough explanation of prostate cancer, including stages, risk factors, and treatment options, from a reputable US cancer organization.
Discusses the complexities and controversies surrounding prostate cancer screening, including PSA tests and DRE, offering a balanced perspective.
Provides patient-friendly information on BPH, its symptoms, diagnosis, and various treatment approaches from a leading urology foundation.
Offers in-depth information on prostate cancer, including risk factors, prevention, screening, diagnosis, and treatment from the US National Cancer Institute.
A curated playlist of videos specifically designed for PLAB 1 preparation, covering key aspects of prostate cancer and BPH.
A clear and concise explanation of the Gleason score, a critical factor in grading prostate cancer, making it easier to understand for medical students.
While not specific to BPH/prostate cancer, this link to a comprehensive urology resource provides access to foundational knowledge and further reading for medical professionals.