Prostat bengkak (an enlarged prostate) is very common in men over 50 and is not usually serious, while kanser prostat (prostate cancer) is the third most common cancer in Malaysian men; both can cause similar problems peeing. Signs include difficulty starting to pee, a weak or stop-start flow, dribbling, and needing to pee often or at night. An enlarged prostate is not caused by cancer and does not raise your cancer risk, but prostate cancer often has no symptoms at first, so any change should be checked by a doctor. An enlarged prostate is treated with lifestyle changes, medicines or surgery; prostate cancer may be monitored or treated with surgery, radiotherapy or hormone therapy. Get urgent help if you see blood in your pee or cannot pee at all.
What is the prostate?
According to the NHS, the prostate is a small gland below the bladder that makes semen and controls the flow of pee from your bladder to your penis. If it gets bigger, it can press on the tube that carries pee out of the bladder (the urethra), causing problems with peeing.
Prostat bengkak or kanser prostat: what is the difference?
| Prostat bengkak (enlarged prostate) | Kanser prostat (prostate cancer) | |
|---|---|---|
| What it is | The prostate getting bigger, thought to be due to hormone changes with age | Cancer that usually starts in the outer part of the prostate |
| How common | Very common, mostly in men over 50 | Third most common cancer in Malaysian men (2017-2021) |
| Symptoms | Problems peeing, which develop slowly | Often none at first; peeing problems, blood in urine or semen, erectile problems if it grows |
| Is it serious? | Not usually; it is not cancer and does not raise your cancer risk | Often grows slowly, but needs specialist assessment |
Sources: NHS; Malaysia National Cancer Registry report 2017-2021. Because the symptoms overlap, a doctor needs to check which one you have.
Tanda prostat bengkak: signs of an enlarged prostate
According to the NHS, the main symptoms of an enlarged prostate are problems peeing, such as:
- difficulty starting to pee, or having to push or strain;
- a weak flow, stopping and starting, and taking longer than usual to empty your bladder;
- feeling like you cannot fully empty your bladder (kencing tak lawas);
- dribbling after you finish peeing;
- needing to pee more often or urgently, including getting up at night.
The symptoms usually develop slowly and may get worse with age. You are more likely to have an enlarged prostate if you are over 50 and others in your family have one. For other causes of needing to pee often, see our guides to kerap kencing and UTI symptoms.
How is an enlarged prostate treated?
According to the NHS, an enlarged prostate does not always need treatment. If your symptoms are not causing many problems, lifestyle changes are usually tried first. Your doctor may examine you, check a urine sample and do a PSA blood test, and may ask you to record how much you drink and pee for at least 3 days.
| Treatment | What it involves |
|---|---|
| Medicines that help you pee | Such as tamsulosin, doxazosin or alfuzosin |
| Medicines for urgency | Such as oxybutynin or tolterodine, if you need to pee often or urgently |
| Medicines that stop the prostate growing | Such as finasteride or dutasteride, by reducing hormone levels, if you are at high risk of it getting worse |
| Surgery | If medicines have not helped or symptoms are severe; the most common is TURP (removing part of the prostate through a thin tube). Other options use lasers, steam, water jets or small implants |
| Support | Bladder training, pelvic floor exercises, pads for leaks, or a catheter if you cannot empty your bladder |
Medicines can cause side effects, so your doctor will explain the benefits and risks and arrange regular check-ups.
Makanan dan gaya hidup: what can you do yourself?
Many men search for foods that shrink the prostate (makanan kecutkan prostat). The NHS does not list any food that shrinks the prostate; its advice focuses on easing symptoms. According to the NHS:
- cut down on alcohol and caffeine, as they can make you pee more;
- drink less before bed or before going out, but drink enough during the rest of the day;
- eat enough fibre to prevent constipation, which can put pressure on your bladder (see our guide to sembelit);
- keep to a healthy weight, as being overweight can make symptoms worse;
- wait a few moments after peeing and then try again, to help empty your bladder;
- ask a doctor or pharmacist whether any medicines you take could be making symptoms worse;
- do not strain when peeing, and do not cut down too much on fluids, as this can cause urinary tract infections.
Ubat prostat: do supplements work?
Many products are sold as the best remedy for the prostate (ubat prostat paling berkesan). The medicines shown to help are prescribed by a doctor (see the table above). The best-known supplement is saw palmetto (Serenoa repens). An updated Cochrane review of 27 trials with 4,656 men found that saw palmetto on its own gives little to no benefit for urinary symptoms caused by an enlarged prostate, compared with placebo.
Supplements are not a substitute for seeing a doctor, especially because prostate cancer can cause the same symptoms.
Kanser prostat: what are the signs?
According to the NHS, prostate cancer often has no symptoms at first, because it usually starts in the outer part of the prostate and does not press on the urethra until it has grown or spread. When it does cause symptoms, they can include:
- difficulty starting to pee or straining, a weak or stop-start flow;
- needing to pee urgently or often, including at night, and feeling you still need to go after finishing;
- erectile dysfunction (being unable to get or keep an erection);
- blood in your urine or semen;
- lower back pain and losing weight without trying, which may be signs of advanced prostate cancer.
These symptoms do not always mean cancer; an enlarged prostate can cause many of them.
Who is more likely to get prostate cancer?
According to the NHS, the risk of prostate cancer increases with age and it mostly affects men over 50. You may be at higher risk if:
- you are over 50;
- you are from a Black African or African Caribbean background;
- you have a family history of prostate cancer;
- a close relative has had pancreatic, breast or ovarian cancer, particularly at a young age, because these can be linked to the same inherited faulty gene (BRCA2).
In Malaysia, prostate cancer was the third most common cancer in men in 2017-2021, after colorectal cancer and lung cancer.
How is prostate cancer checked?
According to the NHS, your doctor may ask about your family history and check your prostate with a rectal examination, gently inserting a gloved, lubricated finger into your bottom. You can ask for a male or female doctor and have someone with you.
- PSA blood test: it cannot tell you if you have prostate cancer, but it can show if there is a problem with your prostate. A raised result can also be caused by an enlarged prostate or a prostate infection (prostatitis). Ask your doctor whether the test is right for you.
- MRI scan: if you are referred to a specialist, an MRI gives a clearer view of the prostate.
- Biopsy: a small needle takes a tissue sample to check for cancer cells.
How is prostate cancer treated?
According to the NHS, prostate cancer does not always need treatment straight away. Because it often grows slowly and may never cause problems, a small cancer that is not causing symptoms may first be monitored with regular tests (watchful waiting or active surveillance). Treatments include:
- surgery to remove the prostate (radical prostatectomy), which can cause leaking pee and erection problems;
- radiotherapy;
- hormone therapy, which stops testosterone fuelling the cancer, used at all stages and with radiotherapy to aim to cure early cancer;
- chemotherapy, mainly if the cancer has spread.
When should you see a doctor?
See a doctor at a klinik kesihatan or a GP if you have difficulty peeing or need to pee more often. Try not to be embarrassed; doctors are used to talking about these symptoms.
Get urgent medical help if you:
- have blood in your pee, which may look pink, red or brown;
- have pain when peeing;
- cannot pee at all.
Talk to a doctor too if you are worried about your prostate cancer risk, even without symptoms.
Frequently asked questions (FAQ)
What are the signs of prostat bengkak (an enlarged prostate)?
The main signs are problems peeing: difficulty starting, having to push or strain, a weak or stop-start flow, feeling your bladder has not fully emptied, dribbling afterwards, and needing to pee more often or urgently, including at night. The symptoms usually develop slowly and may get worse with age.
Is an enlarged prostate the same as prostate cancer?
No. According to the NHS, an enlarged prostate is common, is not usually serious, is not caused by prostate cancer and does not increase your risk of getting it. But the two can cause similar peeing problems, so get any symptoms checked by a doctor.
What are the signs of kanser prostat (prostate cancer)?
Prostate cancer often has no symptoms at first. When it grows, it can cause peeing problems similar to an enlarged prostate, as well as erectile dysfunction, blood in the urine or semen, and, if advanced, lower back pain and losing weight without trying.
What is the most effective medicine for an enlarged prostate (ubat prostat paling berkesan)?
There is no single best medicine; a doctor chooses one based on your symptoms. Options include medicines that help you pee (such as tamsulosin), medicines for urgency (such as oxybutynin) and medicines that stop the prostate growing (such as finasteride). An updated Cochrane review found that saw palmetto on its own gives little to no benefit for urinary symptoms.
Are there foods that shrink the prostate (makanan kecutkan prostat)?
The NHS does not list any food that shrinks the prostate. Its advice focuses on easing symptoms: cut down on alcohol and caffeine, drink less before bed, eat enough fibre to avoid constipation, and keep to a healthy weight.
How common is prostate cancer in Malaysia?
According to the Malaysia National Cancer Registry report for 2017-2021, prostate cancer was the third most common cancer in Malaysian men, after colorectal and lung cancer. The risk rises with age, mostly affecting men over 50.
When should I see a doctor?
See a doctor if you have difficulty peeing or need to pee more often. Get urgent help if you have blood in your pee, pain when peeing, or you cannot pee at all. Also talk to a doctor if you are worried about your prostate cancer risk, for example because of your family history.
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor. Health supplements are not intended to diagnose, treat, cure or prevent any disease.
References
- Enlarged prostate — NHS
- Symptoms of prostate cancer — NHS
- Causes of prostate cancer — NHS
- Tests and next steps for prostate cancer — NHS
- Treatment for prostate cancer — NHS
- Publication of the summary of the Malaysia National Cancer Registry Report 2017-2021 — Ministry of Health Malaysia (via Bernama)
- Franco JVA, et al. Serenoa repens for the treatment of lower urinary tract symptoms due to benign prostatic enlargement: an updated Cochrane review. World J Mens Health. 2024;42(3):518-530
