THE prostate cancer in its initial phase, does not usually present symptoms and has a silent evolution. When patients experience symptoms, they may be similar to benign prostate enlargement including difficulty urinating or an increased desire to go to the bathroom during the day or at night. But, after all, how to differentiate the two diseases?
First, you need to understand what each of the conditions is. Benign prostate enlargement, also called benign prostatic hyperplasia, as the name suggests, is an increase in the number of prostate cells, leading to growth of the gland.
“Benign prostate enlargement is a naturally occurring proliferation of prostate tissue after the age of 40. This proliferation depends on genetic factors, so there are men who are more likely to have benign prostate hypoplasia, but there are also hormonal issues, some men suffer more from testosterone than others”, explains Bruno Benigno, urologist and oncologist at the Hospital Oswaldo Cruz and director of the UroOnco Clinic, at CNN .
According to the expert, other factors may be associated with benign prostate enlargement, such as a sedentary lifestyle, diabetes and the use of testosterone supplementation. “This is an extremely common disease and the most commonly affected age group is men aged 40 and over”, he adds.
Prostate cancer is the abnormal multiplication of prostate cells, forming a tumor. The exact causes for this proliferation are still unknown, but genetic factors (such as mutations in cells that can prevent them from developing normally), age, obesity, a sedentary lifestyle and smoking can increase the risk.
Having a parent or sibling with cancer before age 60 can also increase your risk of having the disease. Additionally, exposures to aromatic amines, arsenic, petroleum products, vehicle engine exhaust, polycyclic aromatic hydrocarbons (PAHs), soot, and dioxins are associated with prostate cancer.
Symptoms are similar, but appear at different times
The main symptoms of benign prostate enlargement include:
- Weak stream of urine;
- Sensation of incomplete emptying of the bladder;
- Waking up several times during the night to go to the bathroom;
- Difficulty urinating.
“In prostate cancer, it’s the opposite. Around 70% of men do not have any symptoms. So, cancer, by nature, is a silent disease, because it generally occurs in the external part of the gland”, explains Benigno. “However, when prostate cancer causes symptoms, largely as a result of the tumor infiltrating the tissues around the bladder, urethra and even the intestine, the patient may have pelvic pain, abdominal pain, difficulty in evacuating, bleeding in urine and bleeding during bowel movements”, says the urologist.
In cases of metastasis, that is, when the cancer has already spread to other areas of the body, the patient may also experience bone pain, muscle pain, a decrease in general health and weight loss.
Tests are necessary to differentiate diseases
Because they have similar symptoms, the way to differentiate prostate cancer from benign prostate enlargement is through physical and laboratory examinations.
“The first of these is to carry out screening based on the patient’s symptoms, age and risk factors. Furthermore, it is important to measure PSA levels in the blood”, explains Benigno. PSA is prostate-specific antigen, a protein produced by prostate cells.
“Men who have a higher PSA are more at risk of developing prostate cancer. Furthermore, the speed at which PSA increases can also be an indication of cancer. Men with cancer tend to have a faster PSA increase than those with benign prostate hyperplasia”, says the expert.
If there is still suspicion, the doctor may request an ultrasound exam to evaluate, in addition to the abnormal growth of the prostate, the presence of nodules in the gland.
“With the suspicion still persisting very strongly, two tests are essential: magnetic resonance imaging, to find foci of nodules that were not seen by ultrasound, and biopsy examination, which is the only way to confirm or rule out the existence of a prostate cancer,” says Benigno.
According to the urologist, the biopsy is an invasive test and, therefore, is not usually requested at the beginning of suspicion of cancer. “Therefore, men follow a screening process, called screening, and only those who have a high suspicion of having prostate cancer undergo this exam”, he adds.
After the differentiation is made, the treatment is defined. For benign prostate enlargement, medications can be used to improve the symptoms of the disease and, in cases of urinary retention, catheterization can be performed to drain the bladder. In some cases, surgical treatment may be indicated to remove excessive tissue in the prostate.
The treatment of prostate cancer may vary depending on the stage of the tumor. For localized disease, surgery, radiotherapy or close observation may be indicated. For advanced disease, radiotherapy or surgery may be used in combination with hormonal treatment. In case of metastasis, the most indicated treatment is hormonal therapy.
This content was originally published in Cancer or benign prostate enlargement? See how to differentiate on the CNN Brasil website.
Source: CNN Brasil
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