The Difference Between Prostate Cancer and BPH

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Both prostate cancer and benign prostatic hyperplasia (BPH) can cause an enlarged prostate, but beyond causing common symptoms, the similarities end there.

During your yearly physical, your healthcare provider might do a rectal exam or request you get a blood test to check your prostate-specific antigen (PSA) level checked. If your prostate is enlarged or your PSA test comes back high, your healthcare provider may do a biopsy to determine if your abnormal results are caused by prostate cancer or BPH. Here's what you need to know about the two conditions and their similarities and differences.

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Understanding Prostate Cancer

Prostate cancer is the most common cancer among men in the United States, with the exception of non-melanoma skin cancer, and typically affects older men. Prostate cancer occurs due to uncontrolled growth of prostate cancer cells. Healthcare providers aren't sure what exactly causes these cells to develop and grow, though.

During the physical examination of your prostate, if you have prostate cancer, your healthcare provider might notice that your prostate feels nodular or bumpy as well as firm and enlarged. Your blood tests will also show a higher PSA and alkaline phosphatase.

Prostate cancer can affect any part of the prostate, but it is usually the lateral lobes, the sides of the prostate, that are affected. In advanced cases, prostate cancer can spread to the bones, but usually only travels to areas within the pelvis.

Common early symptoms of prostate cancer include increased urinary frequency, hesitancy, dribbling, and frequent nighttime urination. How your prostate cancer is treated depends on how aggressive your cancer is as well as your overall health. Treatment can range from close monitoring to surgery, radiation therapyhormonal therapy or a number of other less common options.

Prostate Cancer Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

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What Is Benign Prostatic Hyperplasia? 

Benign prostatic hyperplasia (BPH) is very common in men above the age of 40 and can cause the urinary tract to be obstructed. Unlike prostate cancer, BPH is not cancerous nor is it fatal. As you age, your testosterone levels increase, which, in turn, causes your prostate to grow in size or become enlarged.

During a physical exam, if you have BPH, your healthcare provider will notice your prostate feels larger than it should be. Your PSA tests will also come back elevated. Whereas in prostate cancer, the sides of the prostate are usually affected, in BPH the central portion of the prostate is usually affected. Also, unlike cancer, BPH cannot spread.

The most common symptoms of BPH include urinary symptoms such as frequency of urination, hesitancy, dribbling, and frequent nighttime urination. Depending on the severity of your symptoms, treatment can range from nothing to medication to shrink the prostate, or surgery to remove the central part of the prostate to allow better flow of urine.

Prostate Cancer
  • Cancerous cells present, may spread

  • PSA and alkaline phosphatase elevated

  • Sides of prostate often affected

  • Urinary symptoms

  • Treatment depends on aggressiveness of caner and your health

  • Cells are not cancerous and do not spread

  • PSA elevated

  • Central portion of prostate often affected

  • Urinary symptoms

  • Range of treatment to relieve symptoms

While BPH does not cause prostate cancer, nor do researchers think it is a risk factor. It is possible as well as common to have both at the same time.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. Prostate Cancer Statistics.

  2. Rawla P. Epidemiology of Prostate CancerWorld J Oncol. 2019;10(2):63–89. doi:10.14740/wjon1191

  3. Bhavsar A, Verma S. Anatomic imaging of the prostate. Biomed Res Int. 2014;2014:728539. doi:10.1155/2014/728539

  4. Chang RT, Kirby R, ​Challacombe BJ. Is there a link between BPH and prostate cancer? Practitioner.

  5. National Institute of Diabetes and Digestive and Kidney Diseases. Prostate Enlargement (Benign Prostatic Hyperplasia).

By Matthew Schmitz, MD
Matthew Schmitz, MD, is a professional radiologist who has worked extensively with prostate cancer patients and their families.