BPH and Prostate Cancer
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BPH (Benign Prostatic Hyperplasia) and prostate cancer are male diseases. BPH, as its name already implies, is a benign disease. Generally, around 75% of men older than 75 years have BPH that occurs in the same population of men as prostate cancer (Tu, 2010). Evidently, both of these diseases have common etiological factors, such as diet, androgens, or family history. Though both are affecting the same organ and being the diseases of aging, BPH and prostate cancer differ drastically and demand different treatment.
One of the differences between BPH and prostate cancer is their affected areas. The matter is that “BPH arises primarily in the transition zone of the prostate, whereas prostate cancer arises predominantly in the peripheral zone” (Tu, 2010, p. 122). BPH is an enlargement of the prostate gland present in the majority of men by the eighth decade of life. With the enlargement being significant enough, the urethra becomes constricted, which leads to lower urinary tract symptoms. These can include such voiding symptoms as a weak stream, urinary retention, and intermittency, and such filling symptoms as frequency, urgency, and nocturia (Goroll & Mulley, 2012). Apart from already being a problem, BPH can entail a range of other diseases, because the inability to void the bladder can lead to bladder and kidney infections.
In contrast, prostate cancer can be characterized by the absence of symptoms at the early stages. It remains one of the most wide-spread malignancies diagnosed in men. In 2011, it accounted for almost one-third of them with most men being either asymptomatic “or present with bladder outlet obstruction and bladder irritability” (Yabro, Wujcik, & Gobel, 2013, p. 266). According to the recent findings, African American men show the highest incidence in prostate cancer, while white men are more likely to develop it than Asians, Hispanics, and Native Americans. The most commonly observed type of prostate cancer is adenocarcinoma, with more than 95 percent of all cases being namely of this type.
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Since the difference between these diseases is fundamental, their treatment is also dissimilar. One of the strategies with regards to BPH treatment is observation, which implies monitoring of a patient by his physician with no treatment (only if the symptoms are minimal). Another option is drug therapy involving the use of 5 ?-reductase inhibitors and ?1-adrenergic antagonists that limit the growth of the gland and diminish the strangulation of the urethra by the prostate (Timiras, 2013).
When these two strategies are not successful, symptoms can be reduced either surgically (prostatectomy) or using alternative methods (thermotherapy, androgen suppression, or ultrasound). As far as prostate cancer is concerned, much depends on the patient’s personal preferences, health status, and the extent of the disease. Treatments may include “watchful waiting, surgical procedures […], radiation therapy, hormonal therapy, or cryotherapy” (Timiras, 2013, p. 310). In regards to age differences, young patients are often encouraged to go through aggressive therapies (surgery) to increase their life span.
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In any case, patient education is the most powerful means of preventing these diseases. Age, race, family history, smoking, and diet are the main determinants of BPH and prostate cancer. Therefore, first of all, patients should be informed about these risk factors. Also, some specialists use PSA (prostate-specific antigen) test as a marker for the likelihood that the patient will develop the symptoms of BPH or prostate cancer in the future: “Normally, a small amount of PSA is found in the blood […]. The amount of PSA in the blood varies linearly with the prostate volume” (Timiras, 2013, p. 309). Consequently, the significance of PSA testing in these patients consists of its being able to prevent the development of symptoms in the case with BPH, and detect the disease at early stages in the case of prostate cancer. In this way, patients should also be informed about the necessity of making this test.
In conclusion, BPH and prostate cancer are serious diseases that, nevertheless, can be treated if diagnosed at early stages. Proper patient education and PSA test can help diagnose these diseases earlier, leading to a more favorable clinical course and positive outcomes.