Doctor: Prostate Enlargement Does Not Lead to Prostate Cancer

Dr. Chiang Pei-chang, a urology attending physician at Neihu Tri-Service General Hospital, addressed a common misconception: prostate enlargement does not cause prostate cancer. He explained that these are two separate conditions that can affect the same individual.

Prostate enlargement typically occurs in the transitional zone near the urethra, causing urinary obstruction. In contrast, prostate cancer usually develops in the peripheral zone, often presenting no early symptoms. This difference means that an enlarged prostate can impede urine flow, while early-stage cancer might go unnoticed.

Chiang also clarified that PSA (prostate-specific antigen) levels can rise due to enlargement or inflammation, not solely cancer. Therefore, elevated PSA should not immediately cause alarm but warrants further investigation. He noted that older statistics suggesting a high cancer detection rate in tissue removed during surgery for enlargement are outdated, as pre-operative PSA tests and imaging are now standard, significantly reducing this rate.

Furthermore, Chiang advised that medications used to shrink the prostate (5-ARI) can halve PSA levels after 6-12 months. When interpreting PSA results for patients on this medication, the value should be doubled to accurately assess the situation. He stressed the importance of managing prostate enlargement and continuing regular PSA monitoring as separate but related health concerns.