Introduction
If you’re a man over 50 and experiencing frequent urination, a weak stream, or waking up at night to pee — you’re not alone. These symptoms are very common and often linked to Benign Prostatic Hyperplasia (BPH), also known as an enlarged prostate. However, because these symptoms can also occur in prostate cancer, many men understandably feel concerned.
So, how do you know the difference? In this blog, Dr. Rahul Jena explains the key differences between BPH and prostate cancer, what symptoms to watch for, and when to see a doctor.
What Is the Prostate?
The prostate is a small, walnut-sized gland located below the bladder and in front of the rectum. It surrounds the urethra—the tube that carries urine out of the body—and plays an essential role in producing fluid for semen.
As men age, it’s common for the prostate to grow in size. This growth can be non-cancerous (BPH) or malignant (prostate cancer).
What Is BPH?
Benign Prostatic Hyperplasia is a non-cancerous enlargement of the prostate gland. It is extremely common in men over 50 and is caused by hormonal changes associated with aging.
Common BPH Symptoms:
Frequent urination, especially at night
Weak or interrupted urine stream
Difficulty starting urination
Feeling of incomplete bladder emptying
Urgency to urinate
Dribbling after urination
While these symptoms are uncomfortable, BPH is not cancer and does not increase your risk of developing prostate cancer. However, severe cases can affect kidney function if left untreated.
What Is Prostate Cancer?
Prostate cancer occurs when cells in the prostate gland begin to grow abnormally and form a tumor. It is one of the most common cancers in men, especially after the age of 60. In many cases, prostate cancer is slow-growing, but some types can be aggressive and spread quickly.
Possible Symptoms of Prostate Cancer:
Difficulty urinating or weak stream (similar to BPH)
Blood in urine or semen
Pain in the hips, back, or pelvis
Erectile dysfunction
Unexplained weight loss (in advanced cases)
⚠️ Important: In its early stages, prostate cancer often causes no symptoms at all, which is why regular screening is so important after age 50.
Key Differences Between BPH and Prostate Cancer
| Feature | BPH (Benign) | Prostate Cancer (Malignant) |
|---|---|---|
| Nature | Non-cancerous enlargement | Uncontrolled growth of cancer cells |
| Onset | Gradual with aging | Can be slow or aggressive |
| Symptoms | Mostly urinary | Urinary + possible pain, blood, etc. |
| Risk of Spread | Does not spread | Can spread to bones, lymph nodes |
| PSA Levels | Mildly elevated | May be significantly elevated |
| Treatment | Medication, surgery (non-cancerous) | Surgery, radiation, hormone therapy |
Role of PSA Testing
Both BPH and prostate cancer can cause elevated PSA (Prostate-Specific Antigen) levels in the blood. However, PSA is not cancer-specific.
Mild PSA elevation may occur due to BPH or infections.
Persistently high or rapidly rising PSA levels may indicate cancer.
Dr. Rahul Jena advises routine PSA screening for men above 50, or earlier if there’s a family history of prostate cancer.
Diagnosis: How to Tell Them Apart
To differentiate between BPH and prostate cancer, your urologist may recommend:
Digital Rectal Exam (DRE) – to feel for prostate abnormalities
PSA Blood Test – to measure PSA levels
Ultrasound or MRI of the prostate – for detailed imaging
Prostate Biopsy – if cancer is suspected, tissue is collected for testing
Early detection is key. Dr. Jena emphasizes, “Most men with urinary symptoms assume it’s just aging or BPH. But missing prostate cancer in its early stage can delay life-saving treatment.”
Treatment Options
For BPH:
Lifestyle changes (reduce caffeine, avoid late-night fluids)
Medications (alpha-blockers, 5-alpha reductase inhibitors)
Minimally invasive procedures like TURP (Transurethral Resection of the Prostate)
Laser therapy or advanced surgeries in severe cases
For Prostate Cancer:
Active surveillance (for low-risk cancers)
Robotic-assisted prostatectomy (surgical removal)
Radiation therapy
Hormonal therapy
Chemotherapy or immunotherapy for advanced cases
When to See a Urologist
See a doctor if you:
Have difficulty urinating or need to go often, especially at night
Notice blood in your urine or semen
Experience pain in the lower back, hips, or pelvis
Have a family history of prostate cancer
Are over 50 and have never had a prostate screening
Final Thoughts
While BPH and prostate cancer share similar symptoms, they are very different conditions. BPH is common and treatable, but prostate cancer requires early diagnosis for best outcomes. The only way to know for sure is through medical evaluation.
If you’re experiencing urinary symptoms or are concerned about your prostate health, consult an expert urologist.
👨⚕️ About Dr. Rahul Jena
Dr. Rahul Jena is a leading Uro-Oncologist and Robotic Surgeon based in Bhubaneswar, with vast experience in diagnosing and treating prostate conditions — from BPH to complex prostate cancer cases. His patient-first approach combines advanced technology with compassionate care.