Is BPH a Risk Factor for Prostate Cancer?

Benign prostatic hyperplasia (BPH) and prostate cancer are both conditions related to the prostate gland and can present with similar symptoms. Because of this, some individuals worry that BPH, which is common in older men, is a risk factor for developing prostate cancer. Fortunately, current research shows that having BPH does not increase an individual’s risk of developing prostate cancer.

What is BPH?

BPH is the non-cancerous growth of the prostate gland. This growth comes from an increase in the number of cells within the prostate and is often the result of the normal aging process. A man’s prostate can continuously grow throughout his lifetime, and eventually, may be classified as BPH. BPH can cause the prostate gland to press on the urethra (the tube that runs through the prostate and carries urine from the bladder out of the body), creating difficulties with urination.

The risk of developing BPH increases each year after a man turns 40 years old. It has been estimated that BPH affects 60% of men in their 60’s and 70% of men in their 70’s. The cause of BPH is not well understood; however, it occurs mainly in older men and in fact is the most common prostate problem for men over than the age of 50. Treatment for BPH includes medications or surgery in severe cases.^1,2

Is BPH a precursor to prostate cancer?

Despite both affecting the prostate, both having the potential to affect PSA levels, and both presenting with similar urinary-related symptoms, BPH is not currently considered a risk factor for prostate cancer. Research has suggested that there may be similar factors that can contribute to the development of both BPH and prostate cancer, such as specific genes (genetic markers), inflammation, and hormonal mechanisms. However, there is no evidence that BPH-affected prostate tissue will develop into cancerous tissue as a result of having BPH alone.

For many men, it is common to have both BPH and prostate cancer at the same time and thus it may seem that there is an association between the two. One study which used autopsy data to determine that over 80% of deceased men with prostate cancer also had concomitant BPH. While this number seems high, it’s not too surprising, considering a man’s risk of developing prostate cancer, as well as his independent risk of developing BPH, rises with age. The older a man is, the more likely he is to have developed prostate cancer, BPH, or both.

If I have BPH, what are next steps?

Past and current research seems to agree that BPH is not an independent risk factor for prostate cancer. Because men who have BPH also undergo diagnostic exams for BPH when symptoms arise or become more severe, this screening process may lead to your healthcare provider finding asymptomatic prostate cancer (prostate cancer that is present but isn’t directly causing any symptoms). For this reason, finding and addressing BPH may lead to a higher chance of finding or diagnosing prostate cancer, but the two are still considered by medical researchers to be independent and unrelated.

BPH can lead to some specific complications including acute or chronic urinary retention, blood in the urine, urinary tract infections (UTIs), bladder damage, kidney damage, and bladder stones. Most men with BPH do not develop these additional conditions, however, the potential of kidney damage, in particular, can be a serious health threat when it does occur.

If you have any of these symptoms you should see your healthcare provider, who may refer you to a urologist for testing. Your healthcare provider can discuss treatment options for BPH based on the severity of your symptoms, how much the symptoms affect your daily life and your preferences. You may not need treatment for a mildly enlarged prostate unless your symptoms are bothersome and affecting your quality of life. In these cases, instead of treatment, your urologist may recommend regular checkups.

Recently, there has been some research to suggests that some medications used to treat BPH may actually reduce a man’s risk of developing prostate cancer, however, this link needs to be further investigated. If you receive a diagnosis of BPH and are concerned about your chances of also having or developing prostate cancer, be sure to talk with your healthcare team about additional examinations or diagnostic procedures that they may think are necessary.^2-5