If you’re an older man who deals with urinary problems—like getting up at night to pee, a weak stream or difficulty starting at all—it’s natural to wonder if there’s a deeper issue.

As a urologist at Rocky Mountain Urology Center, concerns about prostate cancer are one of the most common reasons patients come to see me, especially as men age. The good news is that urinary problems in men are often caused by an enlarged prostate—or benign prostatic hyperplasia (BPH)—not cancer.

It’s important to know that BPH does not lead to prostate cancer. That said, untreated BPH can still significantly affect your quality of life and, over time, lead to more serious health problems. Understanding the difference between these conditions can help you seek the right care at the right time.

Understanding the Prostate

The prostate is a small, walnut-shaped gland that is part of the male reproductive system. It surrounds the urethra, which is the tube that carries urine from the bladder out of the body.

The prostate naturally grows larger with age, especially after age 40. As it enlarges, it can begin pressing against the urethra and restrict urine flow, leading to BPH.

Common BPH Symptoms

Men with BPH may experience:

• A weak or slow urine stream
• Having to push or strain to urinate
• A feeling that the bladder is not fully emptied
• Frequent or sudden urges to urinate
• Waking up at night to urinate

How BPH Can Affect Bladder Health

When an enlarged prostate blocks urine flow, the bladder must work harder. Think of it like a pump pushing urine through a narrow pipe. Over time, that strain can weaken the bladder muscle and lead to:

• Muscle damage
• Urinary tract infections (UTIs)
• Bladder stones
• Kidney damage

These changes can be permanent if BPH is left untreated, which is why early evaluation matters to protect your long-term health.

Prostate Cancer

Prostate cancer is the uncontrolled growth of abnormal cells in the prostate and is one of the most common cancers affecting men.

Prostate cancer and BPH can share urinary symptoms, such as frequent or urgent need to urinate, especially at night, a weak urine stream and difficulty urinating. As prostate cancer progresses, additional symptoms may include:

• Burning or pain when urinating
• Blood in urine or semen
• Pain in pelvis, hips or back

Evaluation for prostate cancer may include one or more of the following, depending on patient’s symptoms, risk factors and medical history:

• A PSA (prostate-specific antigen) blood test: Helps assess prostate cancer risk and determine whether further testing is needed.
• Prostate MRI: Helps identify areas in the prostate that may raise concern for cancer and help guide biopsy decisions.
• Prostate biopsy: used to confirm whether cancer is present and how aggressive it is.

Early prostate cancer often causes no symptoms at all, which is why routine prostate health screening is so important. Most prostate cancer is detected in these early stages, when it is highly treatable and often curable. Because treatment decisions vary from person to person, a conversation with your primary care provider or a urologist can help determine the best path forward.

Does BPH Cause Prostate Cancer?

No. BPH does not cause or turn into prostate cancer. These two conditions often occur at the same time because both become more common with age.

However, because they share symptoms, it’s important to see a doctor for proper evaluation to rule out cancer if you’re experiencing urinary troubles.

How We Treat BPH

First-Line Medications

Treatment for BPH often begins with medication, including:

• Alpha‑blockers, which provide quick relief by relaxing prostate and bladder muscles to improve urine flow

• 5‑alpha‑reductase inhibitors (such as finasteride or dutasteride), which shrink the prostate over several months by altering hormone pathways
• Tadalafil, sometimes used off-label to improve urinary symptoms

While these medications can provide symptom relief, they do not cure BPH and may not be ideal for long-term management.

Further Evaluation

If medications are not working, we may recommend further evaluation with a diagnostic tool called a cystoscopy. This procedure uses a small, flexible camera passed through the urethra to see how the prostate is affecting the bladder and urination.

A prostate ultrasound may also be performed to measure the size of the prostate. These tests are quick and help to develop a personalized treatment plan.

Treatment Options When Medications Aren’t Enough

Rocky Mountain Urology Center offers advanced, minimally invasive options to treat BPH when medications aren’t providing effective relief:

• Aquablation is an innovative robotic, heat-free procedure that uses a high-pressure water jet, guided by ultrasound, to precisely and safely remove prostate tissue blocking urine flow. It offers long-term relief, quicker recovery time and minimizes risk of sexual side effects compared to traditional procedures.

• UroLift uses small, permanent implants to lift and hold the prostate open, creating a wider channel for urine to flow. It does not involve cutting, heating or removing tissue and typically allows for rapid recovery and symptom relief.

The Bottom Line

Many men understandably feel anxious about seeing a doctor for their prostate health. While urinary symptoms are common with aging, they’re not something you have to live with —and they’re far more often not cancer.

If urinary issues are affecting your quality of life, a urologist can help determine the cause and guide you towards treatment that best fits your needs and protects long-term bladder and prostate health.

Aashish Kabra, MD, is a board-certified urologist at Valley View’s Rocky Mountain Urology Center, with extensive experience treating all kinds of urologic conditions. Dr. Kabra’s interests range from preventive care to advanced surgical options with minimally invasive techniques when needed. He helped Rocky Mountain Urology Center become a Benign Prostatic Hyperplasia (BPH) Center of Excellence with Urolift and brought the Aquablation BPH procedure to the community.

Dr. Kabra and the Rocky Mountain Urology Center team are welcoming new patients in Glenwood Springs, Aspen, Eagle and Rifle. For more information or to schedule an appointment, call 970.928.0808 or visit https://www.vvh.org/urology.