Prostate Cancer vs BPH: How to Know the Difference

Introduction: The Fear Behind Urinary Symptoms

When men develop urinary problems — frequent urination, weak stream, waking up multiple times at night — one thought often dominates their mind (and their family’s mind):

💭 “Could this be cancer?”

In most cases, the answer is reassuring: these symptoms are usually due to BPH (Benign Prostatic Hyperplasia), a non-cancerous enlargement of the prostate. But because prostate cancer can mimic BPH symptoms, proper evaluation is crucial.

This article explains the key differences between BPH and prostate cancer, when to worry, and how to get the right diagnosis in Mumbai.

What Is BPH (Benign Prostatic Hyperplasia)?

• Definition: Non-cancerous growth of prostate gland, common with aging.
• Cause: Hormonal changes after 50 cause prostate cells to multiply.
• Effect: Enlarged gland compresses the urethra → weak stream, frequent urination.

📌 Key point: BPH = benign, NOT cancer.

What Is Prostate Cancer?

• Definition: Malignant (cancerous) growth in prostate gland.
• Cause: DNA changes in prostate cells → uncontrolled growth.
• Risk factors: Age > 60, family history, obesity, high-fat diet.
• Effect: Tumor may grow silently, sometimes spreading beyond prostate.

📌 Key point: Prostate cancer = malignant, needs active treatment.

Symptoms – How BPH & Cancer Differ

📌 Bottom line: Early cancer can look identical to BPH → symptoms alone cannot differentiate.

PSA Test – Helpful but Not Final

• PSA (Prostate-Specific Antigen): Protein made by prostate, measured in blood.
• High in both BPH & cancer.
• PSA > 4 ng/mL may suggest further testing.
• Not diagnostic alone — can be raised due to BPH, infection, recent ejaculation.

Key Tests to Differentiate BPH from Cancer

1. Ultrasound (USG): Checks prostate size, bladder health.
2. MRI Prostate: Looks for suspicious nodules.
3. Biopsy: Gold standard — confirms/rules out cancer.
4. IPSS Score: Measures severity of urinary symptoms (not cancer-specific).

📌 At Docsy: Free ultrasound at OPDs (Chembur & Pune), plus guidance on advanced tests if needed.

Risk Factors – Who Should Be More Alert for Cancer?

• Men > 60 years
• Family history of prostate cancer
• African/Caribbean ethnicity (lower relevance in India)
• Obesity, high-fat diet
• Very high PSA or rapid PSA rise

Treatment Pathways

If It’s BPH

• Lifestyle changes, medicines, or procedures (TURP, PAE).
• Focus is on relieving symptoms.

If It’s Cancer

• Depends on stage:
  • Localised → Surgery, radiotherapy, or active surveillance.
  • Advanced → Hormonal therapy, chemotherapy.

📌 Key reassurance: Many prostate cancers are slow-growing; not all require aggressive treatment immediately.

Patient Stories

• Mr. Ramesh, 65 (Pune): Had frequent urination. Feared cancer. Ultrasound showed BPH only. Underwent PAE, now symptom-free.
• Mr. Khan, 70 (Chembur): PSA was 6. MRI showed suspicious nodule. Biopsy confirmed early cancer. Treated on time, doing well.
• Mr. Patel, 61 (Andheri): High PSA but biopsy negative. Managed as BPH with medicines, later shifted to PAE.

FAQs – BPH vs Prostate Cancer

Q1. Can BPH turn into cancer?
No. They are separate conditions. BPH does not increase cancer risk.

Q2. Does blood in urine always mean cancer?
No — can also be due to infection, stones, or severe BPH. Needs evaluation.

Q3. Should every man with urinary symptoms get a biopsy?
No. Only if PSA/imaging is suspicious.

Q4. What’s the best test to rule out cancer?
Biopsy, guided by MRI if needed.

Conclusion: Reassurance + Right Diagnosis

Most men with urinary symptoms have BPH, not cancer. But because the symptoms overlap, proper diagnosis — PSA, ultrasound, MRI if needed — is critical.

At Docsy, we ensure you get:

• Free Care Navigator + urologist consultations
• Free ultrasound at partner centres in Mumbai (Chembur & Pune)
• Guidance for advanced tests only if necessary
• Honest, unbiased advice — whether it’s BPH or cancer