- BPH: Benign prostate hyperplasia, which means ‘too many cells’, is enlargement of the prostate that makes it difficult to pee and/or need to urinate many times a day. It is non-cancerous and does not increase your risk of cancer.With early enlarged prostate, lifestyle changes help – stay active to strengthen pelvic muscle tone, cut back on caffeine and alcohol in evenings and try ‘double voiding’ to clear your bladder.
- High PSA Test: An elevated PSA level does not necessarily mean prostate cancer. BPH, prostatitis, recent ejaculation and some medical procedures can also raise PSA levels.
- When to see a doctor: Seek medical advice for persistent urinary symptoms, blood in the urine or semen, unexplained lower back or pelvic pain, or sudden changes in urinary habits. MRI Scan and Biopsy are further diagnostic tests.
As men enter their 60s and beyond, understanding the prostate becomes key to staying healthy and living life to the fullest.
When men reach 50s, 60s and beyond, prostate problems such as benign prostate hyperplasia (BPH), also known as an enlarged prostate, and prostate cancer become more common. While some prostate conditions cause urinary symptoms, early prostate cancer may not cause noticeable symptoms.
Understanding common prostate conditions, recognising symptoms and knowing about tests such as the PSA test can help men take steps to protect their prostate health.
Dr Alvin Lee, Associate Consultant from the Department of Urology at Singapore General Hospital (SGH), a member of the SingHealth Group, explains what men should know about prostate health.
Why is my urine slow and I need to go to toilet often?
As men get older, the prostate often enlarges naturally. This can lead to:
- Urinary symptoms, such as a weak urine stream and frequent urination
- An increased risk of prostate conditions
Common prostate conditions include:
- Benign Prostate Hyperplasia (BPH) – non-cancerous enlargement
- Prostatitis – inflammation of the prostate
- Prostate cancer
What does the prostate do?
The prostate is a small gland located below the bladder. It plays an important role in the male reproductive system by producing fluid that nourishes and transports sperm.
The prostate produces about 25–30% of the fluid that makes up semen. This fluid contains nutrients, enzymes and zinc that help protect sperm, support their movement and keep semen liquid so it can travel through the female reproductive tract.The prostate also contains small muscles that contract during ejaculation to help push semen out.
What is benign prostate hyperplasia (BPH)?
Benign prostate hyperplasia (BPH), also known as an enlarged prostate, is a non-cancerous enlargement of the prostate that can affect urination.
Is BPH the same as prostate cancer?
No. BPH is a non-cancerous enlargement of the prostate, while prostate cancer occurs when abnormal cells grow in the prostate.
How to manage BPH?
How is BPH treated?
Treatment options include:
- Medications
- Minimally invasive procedures, such as Rezum, UroLift and iTIND
What are the symptoms of prostate cancer?
Early prostate cancer may not cause noticeable symptoms.
When symptoms do appear, they may include:
- Difficulty starting or stopping urination
- Weak urine flow
- Frequent urination, especially at night
- Blood in the urine or semen
- Pain in the back, hips or pelvis
These symptoms can also be caused by non-cancerous conditions such as BPH. Proper medical evaluation is therefore important.
What is a PSA test?
The prostate-specific antigen (PSA) test is a blood test used to detect prostate abnormalities.
What should you know about PSA?
PSA test is organ-specific, not cancer-specific.
An elevated PSA level can be caused by:
- Prostate cancer
- BPH
- Prostatitis
- Recent ejaculation or medical procedures
There is no single PSA level that completely rules out cancer. PSA results therefore need to be interpreted together with other tests.
What happens if your PSA is high?
If PSA levels are elevated or a digital rectal exam (DRE) is abnormal, further tests may be carried out.
These may include:
- MRI scan: A multiparametric MRI can help identify suspicious areas.
- Prostate biopsy: A biopsy can be used to confirm a diagnosis.
Modern biopsy techniques use advanced imaging and precision tools to improve accuracy.
What is the difference between BPH and prostate cancer?
BPH / enlarged prostate |
Prostate cancer |
Non-cancerous enlargement of the prostate |
Abnormal cells grow in the prostate |
Can affect urination such as
|
May not cause noticeable symptoms early on
Can cause urinary symptoms when symptoms appear |
Can be managed with medications or minimally invasive procedures |
Treatment depends on the stage and aggressiveness of the cancer |
What is prostate cancer?
Prostate cancer occurs when abnormal cells grow in the prostate gland. It is one of the most common cancers in men in Singapore.
Some prostate cancers grow slowly and may not cause symptoms early on, while others can be more aggressive.
How is prostate cancer diagnosed?
Diagnosis typically involves:
- PSA testing
- Digital rectal examination (DRE)
- MRI imaging
- Biopsy (tissue sampling)
Cancer grading (e.g. Gleason score) helps determine how aggressive the cancer is and guides treatment decisions.
What are the treatment options for prostate cancer?
Treatment depends on the stage and aggressiveness of the cancer.
1. Active surveillance
For slow-growing cancers, doctors may recommend monitoring without immediate treatment.
2. Surgery
Removal of the prostate (prostatectomy) may be recommended for certain cases.
3. Radiotherapy
Modern radiotherapy is highly targeted, reducing damage to surrounding tissues and lowering side effects.
4. Hormone therapy
Used to reduce testosterone levels that fuel cancer growth.
What are the newer treatment options for prostate cancer?
Advances in prostate cancer care have significantly improved quality of life. These include:
- More precise radiotherapy techniques
- Minimally invasive surgery
- Better preservation of urinary and sexual function
These improvements mean many men can continue to lead active, fulfilling lives during and after treatment.
How can you protect your prostate health?
While not all prostate conditions are preventable, you can take steps to reduce your risk:
- Maintain a healthy weight
- Exercise regularly
- Eat a balanced diet
- Go for regular health screenings
- Speak to your doctor about PSA testing
When should you see a doctor?
Seek medical advice if you experience:
- Persistent urinary symptoms
- Blood in the urine or semen
- Unexplained pain in the lower back or pelvis
- Sudden changes in urinary habits
Frequently asked questions about prostate health
Is BPH the same as prostate cancer?
No. BPH is a non-cancerous enlargement of the prostate, while prostate cancer involves abnormal cells growing in the prostate.
Does a high PSA mean prostate cancer?
Not necessarily. PSA is organ-specific rather than cancer-specific. PSA levels can also be elevated by BPH, prostatitis, recent ejaculation or medical procedures.
What happens after a high PSA result?
If PSA is elevated or a digital rectal examination is abnormal, further tests such as a multiparametric MRI or prostate biopsy may be carried out.
What are the symptoms of prostate problems?
Symptoms can include difficulty starting or stopping urination, weak urine flow, frequent urination, blood in the urine or semen, and pain in the back, hips or pelvis. Early prostate cancer may not cause noticeable symptoms.
How is prostate cancer diagnosed?
Diagnosis typically involves PSA testing, a digital rectal examination, MRI imaging and biopsy. Cancer grading, such as the Gleason score, helps determine how aggressive the cancer is and guide treatment.
When should you see a doctor about prostate health?
Seek medical advice if you have persistent urinary symptoms, blood in your urine or semen, unexplained lower back or pelvic pain, or sudden changes in urinary habits.
What do all men need to know about prostate health?
Prostate problems such as BPH and prostate cancer become more common with age, but they can be managed when detected early. Understanding your risk, recognising changes in urinary habits and speaking to your doctor about appropriate screening and PSA testing can help you take the first step towards protecting your prostate health.
Ref: F26
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Benign Prostatic Hyperplasia (Enlarged Prostate): What to Do
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