As men become older, it's likely they will develop a condition called benign prostatic hyperplasia, or BPH. This is a non-cancerous enlargement of the prostate that affects about half of men by age 60 and about 90 percent of men by age 80; of those affected, only a small percentage with significant symptoms usually require treatment.
Though BPH is not cancer, symptoms can be mistaken for prostate cancer, including slower and/or more frequent urination, difficulty urinating, and a feeling of urgency around urination. What’s less clear, however, is how having BPH can affect a man's risk of developing prostate cancer.
A large Danish study, which analyzed data from more than 3 million men between 1980 and 2006, showed that in men who were hospitalized for BPH, the risk of prostate cancer was higher, and death from prostate cancer was higher than the general population. However, while the European study made an association between BPH and prostate cancer, this data does not show causation; in other words, it does not answer the question as to whether BPH causes prostate cancer and, more importantly, aggressive prostate cancer. Also, the study examined a very selective group of men who were hospitalized for BPH, so they already had a severe problem with their prostate and this cannot be extrapolated to a healthy man with BPH.
There are also several conflicting studies suggesting that BPH is actually protective against advanced prostate cancer, and that the risk of having cancer spread outside the prostate is lower than in men with smaller glands.
Based on the available studies, no definitive conclusion can be made regarding BPH and prostate cancer risk; certainly this topic needs to be better researched before such a conclusion can be made. My advice at this time is that while men with BPH should certainly consult a urologist, they should not be overly concerned that their BPH will lead to aggressive prostate cancer.