Prostatitis vs. Prostate Cancer Symptoms and Signs

Prostatitis vs. Prostate Cancer Facts

  • Prostatitis is inflammation of the prostate gland; the four types are acute bacterial prostatitis, chronic bacterial prostatitis, chronic (nonbacterial) prostatitis/chronic pelvic pain syndrome, and asymptomatic inflammatory prostatitis.
  • Prostate cancer develops when abnormal prostate gland cells multiply without control and may metastasize (spread) to other organs.
  • Benign prostatic hyperplasia (BPH) is a noncancerous condition where normal prostate gland cells keep multiplying, thereby increasing the size of the prostate.
  • Prostatitis usually does not lead to death, but prostate cancer is the second leading cause of cancer death in men, even though it is a slow-moving disease.
  • Most men with early prostate cancer have no symptoms or signs; symptoms and signs appear when the cancer (tumor) becomes large enough to cause urinary blockage. Prostatitis, in contrast, usually appears with symptoms such as urinary frequency, urgency and/or pain with urination and possibly, some type of sexual dysfunction.
  • Prostate cancer, when it produces signs and symptoms, may produce one or more of the following symptoms or signs that may also be seen in patients with prostatitis or BPH:
  • Other prostatic cancer symptoms and signs that may be shared less frequently with prostatitis and/or BPH are the following:
  • Prostate cancer symptoms and signs may also include bone/back pain, lower abdominal pain and weight loss, especially if it has metastasized to other organs; BPH and prostatitis do not metastasize.
  • Digital exams of the prostate in patients with prostate cancer usually detects a hard prostate while with prostatitis, the digital exam usually detects an enlarged, tender, warm, firm, and possibly irregular shaped prostate.

What Is Prostatitis?

The prostate gland is a part of a man's reproductive system, secreting fluids that help transport sperm. The gland lies just below the bladder and surrounds the urethra (the tube that drains the bladder).

Prostate infections may irritate the prostate and cause inflammation and swelling of the gland. Prostate infections occur most often in men aged 30-50 years but can occur in older men. Unfortunately, many people equate the terms prostate infection and prostatitis, but prostate infections comprise only two of the four major classifications of the term "prostatitis," and infectious types comprise only a few of the total number of prostatitis diagnosed patients.

The National Institutes of Health consensus panel has designated four types of prostatitis classifications.

  1. Acute bacterial prostatitis
  2. Chronic bacterial prostatitis
  3. Chronic (nonbacterial) prostatitis/chronic pelvic pain syndrome (CPPS; sometimes termed prostatodynia) with subtypes of CPPS termed inflammatory and noninflammatory
  4. Asymptomatic inflammatory prostatitis

Chronic nonbacterial prostatitis may also be occasionally caused by infection; the infectious agent may be at a low level and not found on culture of prostatic secretions. Needle biopsy has also found some patients with difficult to cultivate anaerobic organisms likely causing the infection and may explain why long term-term antibiotic therapy may help some patients with this diagnosis. If an infectious agent is identified by needle biopsy or other tests, the diagnosis should be changed to acute or chronic prostatitis. Chronic nonbacterial prostatitis/CPPS has not been scientifically demonstrated to be primarily either a disease of the prostate or the result of an inflammatory process.


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What Is Prostate Cancer?

In prostate cancer, normal cells undergo a transformation in which they not only grow and multiply without normal controls, but they also change in their microscopic appearance and can invade adjacent tissues. Prostate cancer cells form into malignant tumors or masses, which then overwhelm surrounding tissues by invading their space and taking vital oxygen and nutrients. Cancer cells from these tumors can eventually invade remote organs via the bloodstream and the lymphatic system. This process of invading and spreading to other organs is called metastasis. Common metastatic locations where prostate cancer cells may eventually be found include pelvic lymph nodes, and bones. The lungs and the liver may also show deposits of, or metastases from, prostate cancer, but that is less common.

Almost all prostate cancers arise from the glandular cells in the prostate. Cancer arising from a glandular cell in any organ in the body is known as adenocarcinoma. Therefore, the most common type of prostate cancer is an adenocarcinoma. The most common non-adenocarcinoma is transitional cell carcinoma. Other rare types include small cell carcinoma and sarcoma of the prostate.

Older men commonly have an enlarged prostate, caused by a benign (noncancerous) condition called benign prostatic hyperplasia (BPH). Prostate gland cells simply keep growing in number in the prostate gland in BPH. BPH can cause urinary symptoms but is not a form of prostate cancer (see BPH).

In the U.S., prostate cancer is the most common cancer in men and is the second leading cause of cancer death in men (the first being lung cancer). One men in seven will be diagnosed with prostate cancer in their lifetime. In many cases it can be a slow moving disease and does not result in death before other natural causes. Only one man in 39 will die of prostate cancer. Some 180,000 new cases of prostate cancer are projected this year and there will be 26,000 deaths due to prostate cancer this year.

This low death rate also suggests that increased public awareness with earlier detection and treatment has begun to affect mortality from this prevalent cancer.

Prostate cancer has seemed to increase in frequency, due in part to the widespread availability of serum prostate specific antigen (PSA) testing. However, the death rate from this disease has shown a steady decline, and currently more than 2 million men in the U.S. are still alive after being diagnosed with prostate cancer at some point in their lives.

The estimated lifetime risk of being diagnosed with the disease is 17.6% for Caucasians and 20.6% for African Americans. The lifetime risk of death from prostate cancer similarly is 2.8% and 4.7%, respectively. Because of these numbers, prostate cancer is likely to impact the lives of a significant proportion of men that are alive today.

What Are Signs and Symptoms of Prostate Cancer vs. Prostatitis?

Prostate Cancer Symptoms and Signs

Most men with prostate cancer have no symptoms. This is particularly true of early prostate cancer. Symptoms usually appear when the tumor causes some degree of urinary blockage at the bladder neck or the urethra.

  • The usual symptoms include difficulty in starting and stopping the urinary stream, increase in frequency of urination, and pain while urinating. These symptoms are commonly referred to as "irritative" or "storage" urinary symptoms.
  • The urinary stream may be diminished (urinary retention), or it may simply dribble out and a feeling of bladder fullness after urination can appear as well. These symptoms are commonly referred to as "voiding" or "obstructive" urinary symptoms.
  • It is noteworthy that these symptoms, by themselves, do not confirm or necessarily reflect the presence of prostate cancer in any single individual. Indeed, most, if not all of these can occur in men with noncancerous (benign) enlargement of the prostate (BPH), which is the more common form of prostate enlargement. However, the occurrence of these symptoms should prompt an evaluation by a physician to rule out cancer and provide appropriate treatment.

If the cancer causes a chronic (long-term) or more advanced obstruction, the bladder may be affected and be more prone to recurring urinary tract infections (UTI).

Rare symptoms that may manifest occasionally when the cancer is advanced may include blood in the urine (hematuria), painful ejaculation, and impotence (inability to have an erection).

If the cancer has spread to remote organs (metastasis) symptoms may include fatigue, malaise, and weight loss. Metastasis to the bones can cause deep bone pain, particularly in the hips and back or even bone fractures from weakening of the bone.

Prostatitis Symptoms and Signs

Prostate infections can be classified as acute or chronic; the following describes their symptoms.

Acute bacterial prostatitis: Because acute prostate infection often is associated with infections in other parts of the urinary tract, symptoms may include the following:

  • Increased urinary frequency
  • Urgency to pass urine
  • Pain with urination
  • Difficulty producing a normal stream
  • Pain in the genital area
  • Pain with ejaculation
  • Generalized symptoms that may occur and should be investigated by a caregiver immediately include the following:
    • High fever and chills
    • Generalized malaise and fatigue

Examination usually reveals an enlarged, tender, warm, firm, and irregular prostate. (The doctor should not perform a vigorous digital exam of the prostate to prevent possible spread of the infection to the bloodstream.)

Chronic bacterial prostatitis is defined by NIH as recurrent infection of the prostate. This disease is a common cause of recurrent urinary tract infections (UTIs) in men. Typically, the same strain of bacteria in prostatic fluid or urine will cause the same infection to persist or recur.

Symptoms of chronic bacterial prostatitis may be similar to acute bacterial prostatitis, but are usually less intense. They include the following:

  • Increased urinary frequency along with pain and difficulty urinating
  • Pain in the lower back, testes, epididymis, or penis
  • Sexual dysfunction
  • Low-grade fever, joint pains, and muscle aches
  • Examination may reveal urethral discharge and tender testes, or epididymis.

Stress and depression are common in men with chronic infectious prostatitis.

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Symptom of Prostatitis and Prostate Cancer

Painful Urination

  • Dysuria is the feeling of pain, burning, or discomfort upon urination.
  • Although dysuria frequently indicates the presence of a urinary tract infection (UTI), it can have a variety of causes.
  • Dysuria should always trigger a visit to a health care professional for evaluation and diagnosis.
  • Dysuria is common, accounting for a significant percentage of visits to a primary care doctor.
Cai, T., S. Mazzoli, F. Meacci, et al. "Epidemiological features and resistance pattern in uropathogens isolated from chronic bacterial prostatitis." J. Microbiol 49.3 (2011): 448-454.

Hoffman, Richard M. "Screening for prostate cancer." Jan. 15, 2018. <>.

Kantoff, Philip W., Mary-Ellen Taplin, and Joseph A. Smith. "Clinical presentation and diagnosis of prostate cancer." December 2017. <>.

Klein, Eric A. "Prostate cancer: Risk stratification and choice of initial treatment." December 2017. <>.