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Differentiating between prostate cancer and prostate enlargement

By Dr Ananya Mandal, MD

Many of the symptoms of an enlarged prostate and prostate cancer are similar and the two conditions can be difficult to differentiate.

First and foremost, the patient needs to be told the difference between the two conditions and how prostate enlargement, also known of as benign prostatic hyperplasia (BPH), is not in any way a precursor to prostate cancer.

Digital rectal examination

This involves a healthcare professional using their index finger to feel the prostate gland through the front wall of the rectum to check it for abnormalities. If the gland has grown in size, the enlargement may be detectable with the finger. In BPH, the enlargement feels smooth and firm while in prostate cancer, the gland may feel hard and lumpy. The procedure is not usually painful but may be a bit uncomfortable.

Protein-specific antigen (PSA) assessment

PSA is a protein that is secreted by the prostate gland. PSA is normally present in the blood but the level increases with age and is significantly raised in both BPH and prostate cancer. However, the rise that is seen in the case of BPH is generally not as steep as that seen in prostate cancer.

Transrectal ultrasound examination

For this test, a probe is inserted into the rectum and ultrasound waves are used to detect the prostate gland’s size and to check for tumors. However, this test cannot differentiate between prostate cancer and BPH unless the cancer has spread beyond the prostate.

Transurethral resection of the prostate (TURP)

A surgical procedure called transurethral resection of the prostate is commonly used to treat BPH, by removing pieces of the prostate that are causing obstruction to nearby structures such as the urethra. The physician saves a sample of the excess prostate tissue and sends it for analysis to check for the presence of cancer.

Reviewed by , BSc

Further Reading

Last Updated: Jan 22, 2014

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