Men’s Health Matters: Early Detection of BPH and Prostate Cancer Improves Outcomes

Ibrahim Al-Emadi, MD
Urologist and Transplant Surgeon
Hamad Medical Corporation

Each November, the Movember campaign shines a spotlight on men’s health, encouraging awareness, open dialogue, and proactive medical care. While public attention often centers on prostate cancer, benign prostate conditions such as benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) affect millions of men worldwide and significantly impact quality of life. Addressing the full spectrum of prostate health, from benign to malignant disease, is essential to improving outcomes.

The prostate is a small gland located below the bladder that surrounds the urethra. As men age, the gland often enlarges, narrowing the urinary passage and leading to symptoms known as LUTS. These include urinary frequency, nocturia, weak stream, hesitancy, straining, and a sensation of incomplete bladder emptying. Many men dismiss these symptoms as a normal part of ageing and delay seeking medical advice. However, early assessment is important not only for symptom relief but also to distinguish benign conditions from more serious pathology.

Benign prostatic hyperplasia (BPH) is a histological diagnosis characterized by non-cancerous proliferation of prostatic tissue, whereas benign prostatic enlargement (BPE) refers to an actual increase in prostate size, typically to an overall volume greater than 30 mL. It is important to note that the severity of symptoms does not always correlate with the size of the gland. The global lifetime prevalence of BPH is estimated to be approximately 26 percent, making it one of the most common urological conditions in ageing men [1]. Left untreated, bladder outlet obstruction caused by BPE can progress to urinary retention, recurrent infections, bladder stones, irreversible bladder dysfunction or even renal impairment.

Evaluation begins with a detailed medical history, symptom scoring using validated tools such as the International Prostate Symptom Score (IPSS), digital rectal examination, and urinalysis. Additional investigations such as uroflowmetry, serum creatinine, or post-void residual measurement may be required in selected patients. Primary care physicians play a fundamental role in recognizing LUTS early and initiating appropriate management or timely referral to urology.

Treatment options for LUTS related to BPE are well established and effective. First-line medical therapy includes alpha-blockers, which relax prostatic smooth muscle to improve urinary flow; 5-alpha-reductase inhibitors, which shrink the prostate and prevent progression of enlargement; and tadalafil, a phosphodiesterase-5 inhibitor that can alleviate symptoms while supporting erectile function. For men with inadequate response to medication, minimally invasive procedures such as UroLift or Rezum offer symptom relief with minimal disruption of sexual function. In more advanced cases, surgical intervention remains the gold standard, with transurethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP) offering durable improvements. Importantly, delaying treatment allows chronic obstruction to damage bladder function, making early recognition and intervention critical.

Prostate cancer represents the malignant spectrum of prostate disease and is the second most diagnosed cancer in men worldwide, accounting for 1.2 to 1.4 million new cases annually [2]. Unlike BPH, prostate cancer is frequently asymptomatic in its early stages. When symptoms do occur, they often resemble those of BPH, which reinforces the importance of clinical vigilance. Awareness and education can help men recognize when urinary symptoms warrant medical assessment rather than being attributed solely to ageing.

Early detection of prostate cancer improves clinical outcomes by allowing treatment at a stage when the disease is most curable. Screening is based on serum prostate-specific antigen (PSA) testing with or without digital rectal examination. Large randomized trials, including the European Randomized Study of Screening for Prostate Cancer (ERSPC), have demonstrated that PSA-based screening reduces prostate cancer-specific mortality and lowers the risk of detecting metastatic disease at diagnosis [3,4]. However, prostate cancer screening requires shared decision-making due to the risks of overdiagnosis and overtreatment. Current international guidelines supports offering PSA screening to men aged 50 and above who have a life expectancy greater than 10 years, with earlier screening considered for high-risk individuals such as those with a family history of prostate cancer or African ancestry. Screening is generally discontinued after age 70 unless an individual remains exceptionally healthy.

Management of prostate cancer is based on risk stratification. Low-risk localized disease can often be safely monitored with active surveillance, avoiding unnecessary intervention. Clinically significant localized disease may be treated with radical prostatectomy or external beam radiotherapy. For advanced or metastatic disease, androgen deprivation therapy remains a key component, with newer androgen receptor-targeted therapies and chemotherapy improving long-term survival. Newer options are evolving for metastatic disease such as Lutetium-177 prostate-specific membrane antigen (Lu-177 PSMA) therapy. Treatment selection is individualized based on stage, cancer aggressiveness, patient comorbidities, and preferences [5].

Across the spectrum of prostate disease, a consistent message emerges; early evaluation and shared decision-making improve outcomes. Many men suffer silently with LUTS for years before seeking help, while others miss the opportunity for early detection of prostate cancer. Movember serves as an annual reminder that men’s health deserves attention, not only during one month of awareness but throughout the year. Encouraging proactive evaluation of urinary symptoms and informed consideration of prostate cancer screening can prevent complications, reduce disease burden, and enhance quality of life for men globally.

References

[1] Lee SWH, Chan EMC, Lai YK. The global burden of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a systematic review and meta-analysis. Sci Rep. 2017;7(1):7984.
[2] Rawla P. Epidemiology of Prostate Cancer. World J Oncol. 2019 Apr;10(2):63-89.
[3] Hugosson J, et al. A 16-year follow-up of the European Randomized Study of Screening for Prostate Cancer. Eur Urol. 2019;76(1):43–51.
[4] Schröder FH, et al. Screening for prostate cancer decreases the risk of developing metastatic disease: findings from the ERSPC. Eur Urol. 2012;62(5):745–752.
[5] Cornford P et al. EAU–EANM–ESTRO–ESUR–ISUP–SIOG Guidelines on Prostate Cancer. European Association of Urology (EAU); 2025. Available at: https://uroweb.org/guidelines/prostate-cancer