Prostate cancer is the second most common cancer and the sixth leading cause of cancer death in men. According to reports, more than 10.4 lakh new cases of prostate cancer were recorded in 2020, making it the fourth most commonly diagnosed cancer in the world. Although advancements in diagnostic methods have made it easier for people to detect cancer, many continue to bear the consequences of misdiagnosis, which is possible due to many factors, including when cancer symptoms overlap with benign prostate conditions.
Since November is Prostate Cancer Awareness Month, we spoke to a urologist to differentiate between prostate cancer and other benign conditions and to understand the importance of early detection.
Also Read: PSA Test For Prostate Cancer Diagnosis: Things Men Need To Know About It
Prostate Cancer Misdiagnosis
Misdiagnosis of prostate cancer is very common. According to a study conducted by researchers at Cambridge University, of the 415 men who were told their prostate cancer was less serious and non-life-threatening, half (209) had cancer that was more aggressive than originally thought. This was established after an initial biopsy was conducted. The study published in the British Journal of Cancer also found that a third (131) had cancer that had spread beyond the prostate.
When cancer spreads from the prostate to other parts of the body through tissue, the blood, or the lymphatic system, it is called metastatic or advanced prostate cancer. This can dramatically affect the rate of survival in patients.
A cancer detected early or during a localised stage presents a 5-year relative survival rate of 100%. However, if the prostate cancer has spread to distant sites, a person would have approximately a 30% chance of surviving 5 years, according to the American Cancer Society (ACS).
In certain cases, prostate cancer symptoms can be mistaken for other benign conditions, which can lead to delayed diagnosis and treatment. These include prostatitis and Benign Prostatic Hyperplasia (BPH)
Prostatitis is an inflammation of the prostate gland that can lead to painful and distressing symptoms. According to a study published in the International Journal of Antimicrobial Agents, prostatitis has a lifetime prevalence of 14.2%, with the risk for prostatitis increasing with age. Researchers highlighted that the risk of prostatitis was 1.7 times greater for men 40–49 years old and 3.1 times greater for men 50–59 years old compared to men 20–39 years old.
On the other hand, BPH is a noncancerous enlargement of the prostate gland, which affects about 50% of men aged 51–60, whereas men aged 60–69 and over 70 hold a 70%–80% risk, respectively, according to Yale Medicine.
Symptoms That Can Be Mistaken
Dr Amitava Mukherjee, Senior Consultant Urologist, Fortis Hospital, Anandapur, Kolkata, said, “Symptoms of prostate cancer can overlap with those of benign prostatic conditions, leading to potential misdiagnosis.”
Commonly misinterpreted symptoms include:
- Difficulty in starting or stopping urination
- Poor urine flow
- Incomplete bladder emptying
- Frequent night-time urination
According to the doctor, these symptoms can be attributed to both cancerous and non-cancerous prostate enlargement.
Differences To Note
Prostate cancer and benign conditions, such as BPH or prostatitis, share similar symptoms, but their underlying causes and progression differ, said Dr Mukherjee, adding that while prostate cancer involves the uncontrolled growth of malignant cells in the prostate gland, potentially spreading to other organs, benign conditions, like BPH, result from non-cancerous enlargement of the prostate gland, causing urinary symptoms.
Why Is Early Detection Of Prostate Cancer Important?
Dr Mukherjee said, “Early detection of prostate cancer is essential for successful treatment. While there's no universal recommendation for routine screening, individuals with health concerns or a family history of prostate cancer can opt for a blood test called PSA (prostate-specific antigen) for early diagnosis.”
He concluded, “If symptoms of urinary obstruction arise, a urologist may perform a digital rectal examination (DRE) and order a PSA test. Additional diagnostic tools, such as a prostate biopsy or MRI, may be employed to confirm the presence of cancer. Once diagnosed, further assessment of the disease's spread guides the urologist in determining the most appropriate treatment, such as surgery, radiotherapy, or hormonal manipulation.”