Does BPH Mean Cancer?

Many men suffer from BPH and some of them worry about the condition leading to prostate cancer. Read my thoughts below, in a question-and-answer that appeared in Prostate Forum Volume 14 Number 8.

Dear Dr. Myers: I have had BPH (benign prostatic hyperplasia) problems for several years and my prostate is 2.5 times larger that norm. I’ve been on several medications to reduce size and improve urine flow, without much success.  I’ve had four biopsies, but no cancer detected yet.  However, I feel it is a matter of time.  Just want to get as much info on prostate cancer as I can.  

My answer: BPH is a very common disease in aging men. BPH does not increase your risk of prostate cancer. I would not agree that it is only a matter of time before you get clinically significant prostate cancer. However, BPH may make it difficult to diagnose and treat prostate cancer. Additionally, BPH can make it difficult to urinate and the obstruction of urine flow can damage the bladder or even in extreme cases harm kidney function. As BPH is often accompanied by repeated episodes of prostatitis, the inflammation can cause urgency and discomfort.
At AIDP we would monitor you with color Doppler ultrasound and/or endorectal MRI and would stay away from frequent biopsies. Every time you have a biopsy, you are at risk for a serious infection.
With a gland this size, we would definitely start with Avodart and a drug like Flomax or Rapaflo. BPH tends to be associated with low vitamin D levels and we would correct that as quickly as possible. We would also look to reduce inflammation as completely as possible.
There is some evidence that BPH is fostered by estrogen and with your large gland, we would check serum estradiol and estrone levels.
BPH seems to be much more common in those on a diet rich in red meat and low in vegetables and fruit. We would advise you to make a diet change as the same dietary issues are associated with heart attack, stroke and diabetes.
Overall, patients on this combined approach do quite well and many are able to avoid surgery.


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