BPH and Prostate Cancer: Is There a Connection?

At the Sperling Prostate Center, we are taking an increasing interest in benign prostatic hyperplasia (BPH). Two main reasons are:

  • We are building our practice and our professional network with men’s health as our larger vision, and
  • We now offer image-guided focal laser ablation (FLA) as an effective and efficient way to control the troubling urinary problems of BPH with no downsides.

BPH is a normal enlargement of the prostate gland as men age. To learn more, see http://sperlingprostatecenter.com/need-know-benign-prostatic-hyperplasia/. As the word “benign” suggests, this condition is not cancerous. It is not life-threatening, but we know that aggravated urinary problems certainly make a dent in quality of life.

Some of my patients have asked if BPH can trigger or turn into prostate cancer (PCa). That’s a very good question. Cancer Research UK advises, “It is possible for men with BPH to go on to develop prostate cancer as well. But there is no clear evidence to suggest that having BPH leads to, or increases, the risk of prostate cancer.”[i] The U.S. National Library of Medicine’s patient website, MedlinePlus, agrees that BPH does not raise the risk of developing prostate cancer.[ii]

A team of German researchers tackled data from the Montreal PROtEuS (Prostate Cancer and Environment Study) a large population-based, case-controlled study. The team selected study questionnaire responses from 3,927 men across Montreal French hospitals. They were divided into two groups: 1933 questionnaires from men who had been diagnosed with PCa between 2005-9, and 1994 from men (same age and residential areas) who did not have PCa. The PROtEuS study generated a large pool of data that could potentially correlate many factors with PCa, such as allergies and how many sex partners a patient had (the report that men with 20 or more sex partners over their lifetime had lower rates of PCa made the news![iii])

The German team used the PROtEuS study to explore correlations among

  • prostate cancer
  • any history of BPH prior to cancer diagnosis
  • BPH history reported at least one year before interview/diagnosis, and
  • exposure to BPH medications.[iv]

In addition to the questionnaires, they conducted in person interviews to gather medical histories (BPH diagnosis, duration and treatment, PCa screening, demographics).

After analyzing all the data, they determined that a history of BPH was associated with an increased incidence of low-grade PCa, though the association was not statistically significant if the BPH diagnosis was more than a year prior to the interview. They also determined that medication commonly prescribed to relieve urinary symptoms, 5? reductase inhibitors (5?-RI) such as Avodart, Proscar, etc. “resulted in a decreased risk of overall PCa… particularly for intermediate- to high-grade PCa…”

It is important to remember that a correlation such as men with a history of BPH having a greater incidence of PCa than men with no history does not mean that BPH leads to cancer, or causes cancer. There are many factors that can lead to PCa, and for each individual who is diagnosed with the disease, there is probably a unique combination that triggered the beginning of cancer cells. These factors may include (but are not limited to) genetic mutations, family history, aging and the breakdown of DNA, environmental toxins, repeated inflammations that irritate the cells, ethnicity, etc. No one knows why one person exposed to the same factors will develop PCa while another won’t.

So if you are diagnosed with BPH, it’s probably because you’re experiencing frequent or difficult urination, interrupted night sleep, or other symptoms. Your greatest headache will be those pesky urinary difficulties, but there are many ways to handle them. Keep in mind that MRI-guided FLA is a great outpatient treatment with a very rapid recovery and no side effects—and it eliminates the need for medication.

If you are concerned that you might have BPH, get a professional diagnosis including multiparametric MRI of the prostate. No matter what the outcome, don’t worry about prostate cancer.


 

[i] http://www.cancerresearchuk.org/about-cancer/cancers-in-general/cancer-questions/can-an-enlarged-prostate-turn-into-cancer

[ii] http://www.nlm.nih.gov/medlineplus/ency/article/000381.htm

[iii] http://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines/news/2014-10-29-could-sex-with-21-women-cut-prostate-risk/

[iv] Boehm K, Valdivieso R, Meskawi M et al. BPH: a tell-tale sign of prostate cancer? Results from the Prostate Cancer and Environment Study (PROtEuS). World J Urol. 2015 Apr 1. [Epub ahead of print]