Dr Peter Joseph, Urologist, Mitraa Hospital, Madurai, sheds light on several prostate diseases.
BPH vs Prostate Cancer: Prostatic diseases are common among ageing men, and they cause significant morbidity. They manifest in 3 common forms – Benign Prostatic Hyperplasia (BPH), prostate cancer and prostatitis (inflammation of the prostate gland). Among these, the most common is BPH which is a non-cancerous enlargement of the prostate gland. Very commonly present in ageing and older adults. BPH is benign, which means it’s not cancer and it can’t spread. According to Dr Peter Joseph, Urologist, Mitraa Hospital, Madurai, “BPH and prostate cancer are often confused as they have similar symptoms. Therefore, it’s sometimes hard to tell the two conditions apart. When the prostate grows, it squeezes the urethra. While in the Prostate cancer symptoms often don’t start until cancer has grown large enough to put pressure on the urethra.”
What are the latest estimations of Global Cancer Observatory?
- According to the latest Global Cancer Observatory (GLOBOCAN) estimates, there are more than 25,000 new cases of and over 17,000 deaths due to prostate cancer in India every year. Though cancers, in general, are rarer as compared to ailments like hypertension, diabetes and BPH, among all cancers, prostate cancer is the two ends or 3rd most common cancer in males across major cities of India. The trends of prostate cancer in India show a tremendous increase over the past several decades and are projected to rise further owing to our increasing elderly male population, adoption of Western lifestyle, urbanization and raising public awareness. What exactly causes prostate cancer? We know for sure that increasing age (significantly above 50) and positive family history of prostate cancer (e.g. in father, brother or close uncle, etc.) are important risk factors.
- According to Dr Peter Joseph, Urologist “Unlike BPH (which is a non-cancerous condition), prostate cancer is a malignant or cancerous growth or tumour of the prostate and has far more serious implications. This is basically because unlike BPH, it tends to spread outside the prostate gland to either nearby as well as to distant organs and structures and cause damage.”
- Prostate cancer can be categorized as Localized (cancer confined totally within prostate gland), locally advanced (cancer has spread to organs and structures adjacent to the prostate gland such as large intestine, urinary bladder, adjacent muscles and lymph nodes) and metastatic (cancer has spread to distant sites).
- Among the remote places, it has an affinity to spread or metastasize to bones, especially the weight-bearing bones like lower vertebrae and big bones of the hip and thighs. The deposition of the tumour at these essential sites can lead to compression of the spinal cord inside the vertebral canal (causing paralysis below the waist), severe bone pains (manifest as back pain) and even fractures of weight-bearing bones.
Hence, it is vital that the patient initially undergoes a per rectal examination by his doctor. This involves palpation of the prostate with a gloved finger by a doctor to check if it has a cancerous or ‘hard’ feel. This simple screening test, in conjunction with serum PSA levels, serves as a cost-effective screening mechanism before going for more advanced investigations mentioned above in a developing country like ours which has a vast population but limited resources.
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