How Do I Know If I Have BPH And Not Prostate Cancer?
Prostate cancer may present with symptoms similar to BPH, although in the early stages there are no symptoms. To determine if prostate cancer is present your Doctor will perform tests.
- The main test is the digital rectal examination (DRE). This is a simple examination in which the doctor will pass a lubricated, gloved finger into the rectum. Because the prostate is located just in front of the rectum, it can be easily palpated. Enlargement can be detected as well as any lumps or firm areas, which can suggest the presence of prostate cancer.
- Your doctor may also do other tests including checking your prostate specific antigen (PSA). PSA is a substance produced by the prostate, which can be measured by a blood test. Prostate cancer often releases more PSA into the blood than a normal prostate. Elevated levels of PSA suggest the presence of prostate cancer, although BPH and prostatitis may also cause elevated levels. Your physician may use the estimated size of your prostate and/or your PSA level to determine your risk of future progression and problems.
- If there is a suspicion of prostate cancer following the digital rectal examination, e.g. a nodule or firm area, and/or an abnormal PSA test, then a biopsy will usually be done. This causes minimal discomfort and is usually performed by inserting a needle into the prostate through the rectum. The needle is usually guided by the use of transrectal ultrasound (TRUS). TRUS involves the insertion of a probe, slightly larger than the index finger, into the rectum. TRUS displays an image of the prostate on a screen, permitting accurate placement of the biopsy needle into selected areas of the prostate. Occasionally, the doctor may use a finger in the rectum to guide the biopsy. The majority of men presenting with symptoms of BPH do NOT have prostate cancer, and will not require biopsy.
What Other Tests Will Be Required To Diagnose BPH?
A urine specimen will be examined to detect the presence of blood or infection. Depending upon your symptoms, other tests may be performed such as:
- Blood Test
This will check the kidney function.
- Abdominal Ultrasound
This painless test involves placing a probe on the abdomen to visualize the kidneys and bladder.
- Intravenous Urography
This is an x-ray where an injection is given into the blood stream to visualize the kidneys and bladder.
A small telescope is passed through the urethra into the bladder, permitting examination of the urethra, prostate and bladder. Local anesthetic is placed in the urethra, and the procedure causes only minimal discomfort.
- Urine Flow Study
You will urinate in your usual manner into a special container, which measures the strength of the flow, and can help determine the severity of the blockage.
- Residual Urine
This test, done either by abdominal ultrasound or passing a catheter into the bladder, measures how well you empty your bladder.
This test measures urine flow, residual urine and bladder volumes and pressures, and involves a small catheter being inserted through the urethra into the bladder.