Prostate health: Understanding BPH and cancer screening
Two issues, one gland
With age, the prostate undergoes natural changes that can raise questions. Two main topics emerge: benign prostatic hyperplasia (BPH), a very common condition that affects urinary comfort, and the question of prostate cancer screening.
It is important to know that these are two completely distinct medical conditions. Understanding the nuances of each is essential for navigating follow-up and treatment options in an informed way.
Benign Prostatic Hyperplasia (BPH)
What is it?
BPH is a normal, non-cancerous enlargement of the prostate gland, a phenomenon that affects the majority of men as they age. As it enlarges, the prostate can press on the urethra and cause urinary difficulties.
Symptoms and their impact on quality of life
The symptoms of BPH can have a significant impact on daily quality of life. They include:
- A frequent or urgent need to urinate, day and night.
- a weak, intermittent, or difficult-to-start urine stream.
- The sensation of not completely emptying the bladder.
The solutions: The pharmacological approach
Fortunately, it is not necessary to endure these discomforts. Very effective medications exist to relieve symptoms:
- Alpha-blockers (e.g., tamsulosin): This is often the first-line treatment. They work by relaxing the muscles of the prostate and bladder.
- 5-alpha-reductase inhibitors (e.g., finasteride, dutasteride): These medications work by reducing the size of the prostate over several months.
- Combination therapies: Sometimes, the two classes of medication are combined for maximum effect.
Prostate cancer screening: A shared decision
The PSA test
Screening is primarily based on a blood test for prostate-specific antigen (PSA). The level of this protein can increase in the presence of cancer, but also for other reasons (like BPH).
The crucial nuance: why routine screening is no longer recommended
It was realized that routine screening led to overdiagnosis and overtreatment of slow-growing cancers that would never have caused a problem, while exposing men to the side effects of treatments.
The informed decision
The current recommendation is for a shared decision. The decision to do a screening test or not is a personal choice that should be made after a discussion with your healthcare professional about the pros and cons.
BPH vs. Cancer: Not to be confused
This is a very important point to remember: having benign prostatic hyperplasia (BPH) does not increase your risk of developing prostate cancer. They are two distinct conditions.
What your pharmacist can do for you
For all questions concerning urinary symptoms or the management of medications for BPH, your pharmacist is a first-line resource. We are here to advise you and ensure the safe follow-up of your treatment.
Trusted resources
For Benign Prostatic Hyperplasia (BPH)
-
Canadian Urological Association (CUA) (EN/FR)
- Offers a very clear, medical information sheet on the causes, symptoms, and treatment options for BPH.
-
- The patient information site from the American Urological Association. It is an extremely complete and high-quality resource.
For Prostate Cancer Screening
-
Canadian Cancer Society - Page on screening (EN/FR)
- THE Canadian reference. Their section on screening is very nuanced and perfectly explains the "shared decision" approach.
-
Canadian Cancer Society - Decision aid tool (EN/FR)
- This specific page is designed to help men weigh the pros and cons of the PSA test. It is a much more accessible resource than the INESSS PDF.
