Normally when we talk about an enlarged prostate (aka, benign prostatic hyperplasia, or BPH), we discuss the symptoms, lifestyle challenges, available treatments, and ways to cope with this common prostate condition. Yet researchers recently reported on an unusual and possibly positive feature of BPH; that is, an enlarged prostate may stop prostate tumor growth.
Enlarged prostate and prostate cancer
Symptoms of an enlarged prostate and prostate cancer are very similar, so it is important to see your doctor if you are experiencing the urinary tract indicators of these two prostate conditions. The more common ones include urinary frequency, urinary urgency, dribbling, pain when urinating, the need to urinate several times during the night, weak stream, and urinating in fits and starts.
Men who have an enlarged prostate are not at a greater risk of developing prostate cancer. However, it is possible to have both BPH and prostate cancer at the same time. When this is the case, physicians and their patients must decide how to approach treatment.
Can an enlarged prostate stop prostate tumor growth?
According to the findings of a new study, men who have both an enlarged prostate and prostate cancer may want to avoid treating the BPH. That’s because having an enlarged prostate may actually stop growth of their prostate tumor.
Treating an enlarged prostate with surgery or drugs in this population of men could result in the prostate cancer growing faster. Even though the five-year survival rate for prostate cancer is about 99 percent, this form of cancer is still a primary cause of death among men in the United States.
It’s also important to point out that some men may develop aggressive prostate cancer even if it seems to be limited to the prostate.
The study, which appeared in the Proceedings of the National Academy of Sciences, involved computer simulations that help researchers understand tumor growth, blood flow, and cell migration. It was the first study to simulate the possible impact of an enlarged prostate on prostate cancer tumors.
The computer simulations suggested that when a man has an enlarged prostate and prostate cancer, force from the enlarged prostate puts pressure on the tumor, which in turn keeps it small. The simulations were conducted by a team of researchers and headed by Guillermo Lorenzo, a postdoctoral researchers at the University of Pavia in Italy. The computer simulation project was started by Hector Gomez, associate professor of mechanical engineering at Purdue University, and Thomas Hughes, a professor of aerospace engineering and engineering mechanics at The University of Texas at Austin.
Currently it is challenging to identify which prostate cancer patients are at great risk and those who are not. Use of this computer simulation could be one way to help doctors better understand patient risk.
The study used data from men who had a history of both an enlarged prostate and prostate cancer. Using three-dimensional images of the patients’ prostate and tumors from MRI images, Lorenzo and his team found that after one year, men with an enlarged prostate had a tumor that barely grew. When the researchers eliminated a history of an enlarged prostate from the program, tumors grew more than six times larger.
Hughes noted that from these findings, “now we know that the mechanical stresses that originate as prostates enlarge impede tumor growth.” For now, these findings must be validated in humans using a long-term observational study before doctors can take action. However, the computer simulator researchers are moving ahead to explore the impact of drugs on an enlarged prostate.
Lorenzo G et al. Computer simulations suggest that prostate enlargement due to benign prostatic hyperplasia mechanically impedes prostate cancer growth. Proceedings of the National Academy of Sciences USA 2019 Jan 22; 116(4): 1152-61
Prostate Cancer Foundation. Prostate cancer survival rates.