Benign Prostatic Hyperplasia and Prostate Cancer

Benign Prostatic Hyperplasia (BPH) and prostate cancer are the most common diseases of the genitourinary system in men, which occurs in every second man over 60 years of age. Still, they can also occur at the age of 40-50 (Chang, Kirby, & Challacombe, 2012). The key manifestations of BPH are painful urination, feeling of incomplete emptying of the bladder, weakening of the urine stream, and an increase in the duration of urination.

Often there is acute retention of urine, in which self-urination becomes impossible, and emergency medical care is required. The main causes of BPH are age-related hormonal changes in the body of men. Elkahwaji (2013) notes that inflammatory mediators may also generate BPH. In its turn, prostate cancer symptoms can be conditionally divided into three groups: symptoms of urine outflow from the bladder (intravesical obstruction), symptoms related directly to the growth of the prostate tumor (blood in urine and semen, erectile dysfunction, perineum, etc.), and symptoms associated with metastatic prostate cancer (Miah & Catto, 2014).

These patients need precise and effective screening. For BPH, uroflowmetry, transabdominal ultrasound, digital rectal examination (DRE), etc. can be utilized. To differentiate between cancer prostate and BPH, one should conduct Prostate-Specific Antigen (PSA) testing. This is the only way to diagnose cancer accurately. PSA is the most important tumor marker, the study of which is necessary for diagnosing and monitoring of prostate cancer. Taken in combination, “a normal PSA, PSA density, and DRE can give reasonable confidence with regards to excluding clinically significant prostate cancer” (Chang et al., 2012, p. 13).

Haj-Ahmad, Abdalla, and Haj-Ahmad (2014) propose the significance of the specific urinary miRNA biomarker that refers to non-invasive and urine-based tests. In their study, the authors claim that the “sensitivity and specificity for miR-1825/484 in tandem were 45 percent and 75 percent, respectively” (Haj-Ahmad et al., 2014, p. 182). These results show that there is a need for prospective research aimed at the development and subsequent implementation of innovative measures to detect BPH and cancer prostate at early stages.

More to the point, a prostate biopsy is one of the most valuable methods for diagnosing prostate cancer and differentiation with various other processes in the prostate gland that implies the histological examination of pieces of tissue obtained by biopsy. Indications for prescribing a prostate biopsy are PSA level and/or suspicious areas detected during DRE (Liu, Peng, Zhou, & Wang, 2013). HistoScanning is one more technology of differentiation, characterization, and visualization of the prostate tissue that is based on the analysis of the backscattering of ultrasound. This device can conduct an ultrasound scan of the prostate gland with a high degree of accuracy, revealing the areas of tissue that are suspicious of cancer.

Plenty of researchers view the treatment of BPH and prostate cancer. Ilic and Misso (2012) assume the role of lycopene that cannot be either supported or rejected by the existing evidence. The traditional surgical procedures for BPH include open or laparoscopic adenomectomy, transurethral electroreception, or laser enucleation of prostatic hyperplasia (Krambeck, Handa, & Lingeman, 2013). Currently, the preference is given to minimally invasive operations, in which access to the prostate is made through the urethra. For prostate cancer, there are such options as removal of the prostate gland (radical prostatectomy), radiation therapy of prostate and adjacent lymph nodes, HIFU-therapy, brachytherapy, interstitial radiation therapy, and cryoablation of the prostate.

References

Chang, R. T. M., Kirby, R., & Challacombe, B. J. (2012). Is there a link between BPH and prostate cancer? The Practitioner, 256(1750), 13-17.

Elkahwaji, J. E. (2013). The role of inflammatory mediators in the development of prostatic hyperplasia and prostate cancer. Research and Reports in Urology, 5(1), 1-10.

Haj-Ahmad, T. A., Abdalla, M. A., & Haj-Ahmad, Y. (2014). Potential urinary miRNA biomarker candidates for the accurate detection of prostate cancer among benign prostatic hyperplasia patients. Journal of Cancer, 5(3), 182-191.

Ilic, D., & Misso, M. (2012). Lycopene for the prevention and treatment of benign prostatic hyperplasia and prostate cancer: A systematic review. Maturitas, 72(4), 269-276.

Krambeck, A. E., Handa, S. E., & Lingeman, J. E. (2013). Experience with more than 1,000 holmium laser prostate enucleations for benign prostatic hyperplasia. The Journal of Urology, 189(1), 141-145.

Liu, X., Peng, W., Zhou, L., & Wang, H. (2013). Biexponential apparent diffusion coefficients values in the prostate: Comparison among normal tissue, prostate cancer, benign prostatic hyperplasia and prostatitis. Korean Journal of Radiology, 14(2), 222-232.

Miah, S., & Catto, J. (2014). BPH and prostate cancer risk. Indian Journal of Urology, 30(2), 214-218.

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