The prostate is a walnut-sized gland that sits just below the bladder and helps produce the fluid in semen. The prostate normally grows as you age. In fact, it can reach about the size of a baseball by the time you’re 60. While some age-related growth is typical, other changes can signal problems with the prostate gland, such as benign prostatic hyperplasia (BPH) or prostate cancer.

BPH and prostate cancer are separate conditions that share some similarities at a glance. For one, they can both involve prostate growth beyond what’s considered normal. They also have major differences, including their prognoses (disease course or outcome) and how they’re treated. If you notice potential symptoms of either condition, it’s important to get an accurate diagnosis as soon as possible.

Here, we’ll discuss the similarities and differences between BPH and prostate cancer so you can have better discussions with your doctor.

What Is Benign Prostatic Hyperplasia?

Benign prostatic hyperplasia is also known simply as an enlarged prostate. BPH occurs when prostate tissue overgrows due to causes unrelated to cancer. BPH can cause many concerning symptoms and it’s one of the most common reasons why someone may visit the urologist as they age. However, BPH doesn’t increase the risk of getting prostate cancer later on.

As the prostate slowly grows larger with BPH, it can place pressure on the bladder. This pressure is the underlying cause of many common BPH symptoms, like needing to pee often or discomfort when you pee.

BPH is extremely common. About half of people with prostates develop symptoms of BPH by age 60, according to Cleveland Clinic, and by age 85, 90 percent have developed signs of the condition.

Although BPH is a common condition, you shouldn’t ignore its symptoms. It shares many symptoms with prostate cancer, so it’s important to talk to a doctor if you notice any. Plus, when left untreated, BPH can cause serious complications like urinary tract infections (UTIs), kidney stones, and kidney damage.

What Is Prostate Cancer?

Prostate cancer occurs when cancer develops from abnormal prostate cells, causing them to multiply faster than usual and form a tumor. Eventually, if it’s not diagnosed and treated, the cancer can metastasize (spread to other parts of your body) and become life-threatening. Prostate tumors usually grow quite slowly, though, so many people are able to find them and get treatment before this happens.

Prostate cancer isn’t as common as BPH, but around 13 percent of males will develop prostate cancer in their lifetime, according to Cleveland Clinic.

It’s important to talk to your doctor about getting prostate screenings starting at age 55, or earlier if you’re at a higher risk. Screening tests involve a blood test for levels of prostate-specific antigen (PSA), or sometimes a digital rectal exam (DRE). If these show signs of possible prostate cancer, your doctor will recommend a biopsy to confirm or rule out a prostate cancer diagnosis.

Shared Symptoms of BPH and Prostate Cancer

Prostate cancer and BPH share many of the same symptoms. Prostate growth in both cases can cause changes in the way you urinate that slowly worsen as the prostate presses on the bladder or urethra.

Symptoms of both BPH and prostate cancer can include:

• Trouble peeing
• A weak or dribbling urine stream
• The urgent need to pee, especially at night
• Pain while peeing
• Urinary incontinence (leaking or trouble holding your urine)
• Trouble fully emptying your bladder when you pee
• Blood in your pee

Early-stage prostate cancer might not cause these symptoms, but they can develop as cancer progresses. On the other hand, BPH can cause these symptoms early on.

Symptoms of Advanced Prostate Cancer

As prostate cancer advances, it can cause additional unique symptoms. You’re more likely to see blood in your urine or semen with prostate cancer as it progresses. You might also eventually feel aches or bone pain in your hips, pelvis, low back, or chest.

In some cases, advanced prostate cancer symptoms can include fecal incontinence (trouble holding in your poop) if it has spread to the spine, which is not a symptom of BPH.

Risk Factors of BPH and Prostate Cancer

Health specialists aren’t sure of the exact causes of BPH, and they don’t know exactly what causes prostate cancer either. However, they know that both conditions have risk factors that increase your chances of developing them. They have some shared and some different risk factors.

Risk factors for BPH include:

• Age — You’re more likely to develop BPH if you’re over 40 years old.
• Genetics — If you have family members with BPH, you’re more likely to get it.
• Lifestyle — Not getting regular physical activity may raise your chances of developing BPH.
• Certain health conditions like diabetes, heart disease, obesity, and erectile dysfunction put you at a higher risk for an enlarged prostate.

Prostate cancer risk factors include:

• Age — You’re more likely to develop prostate cancer if you’re over 50 years old, but you might not be diagnosed for years or decades after that.
• Race and ethnicity — African Americans are more likely to develop prostate cancer than people of other racial and ethnic groups.
• Genetics — As with BPH, you’re more likely to develop prostate cancer if you have a first-degree relative who has it. Certain gene mutations (changes) can also increase your risk.
• Lifestyle — Smoking increases your risk of developing prostate cancer and other cancers.

Remember that BPH isn’t a risk factor for prostate cancer, even though the two conditions can appear similar based on their symptoms.

Treatments for BPH vs. Prostate Cancer

BPH and prostate cancer receive very different types of treatment.

BPH Treatment

BPH isn’t curable, but your doctor can recommend lifestyle changes, medications, or minimally invasive procedures to reduce your symptoms. They consider your overall health and the size of your prostate while making recommendations.

Your doctor might suggest drinking less water, alcohol, and other fluids before bed so you don’t have to get up as often at night to go pee. They might also recommend bladder training strategies to help you manage the urinary symptoms of BPH.

Some prescription medications can help relax the muscles in your prostate, which might help reduce tension around your urethra to alleviate urinary symptoms.

Other medications for BPH work by reducing the production of a hormone called dihydrotestosterone (DHT), which drives prostate growth. These medications can help slow your prostate growth so your BPH doesn’t worsen as quickly.

Combination medications both relax the muscles in your prostate and reduce DHT production.

Prostate Cancer Treatment

Prostate cancer treatment depends on many factors, including the stage of your prostate cancer. If it’s at an early stage, your doctor might recommend watchful waiting (also called active surveillance), which means keeping an eye on the cancer until it spreads or grows larger.

Later-stage prostate cancer may be treated with systemic treatments that target cancer throughout the body, localized treatments for cancer still in the prostate, or a combination of both.

You and your oncologist may decide to treat your prostate cancer with one or more of these common therapies:

• Surgery
• Radiation therapy
• Hormone therapy
• Immunotherapy
• Targeted therapy
• Chemotherapy
• Cryotherapy or light therapies

Read details about treatment options for prostate cancer.

Surgery To Remove Prostate Tissue

Treatment for BPH and treatment for prostate cancer can both involve prostate removal surgery. For BPH, doctors usually only recommend surgery if the enlarged prostate has damaged the bladder or if symptoms are severe.

Surgery for BPH can also involve cutting the prostate to widen the urethra, making it easier for you to pee.

Prognosis of BPH vs. Prostate Cancer

BPH and prostate cancer have widely different prognoses.

BPH doesn’t affect your life expectancy, and treatments can alleviate many of the symptoms. You might not need any treatment if your symptoms are mild. In short, you have a good outlook with BPH.

Prostate cancer also typically has a good outlook when it’s diagnosed early. When prostate cancer is diagnosed before it’s spread outside of the prostate gland, it has a 99 percent five-year survival rate. That means that 99 percent of people diagnosed with prostate cancer in an early stage are still alive five years after their diagnosis.

The five-year survival rate is about 32 percent for metastatic (stage 4) prostate cancer, which has spread to other parts of the body.

Your oncologist can recommend treatment options for any stage of prostate cancer. Work closely with your oncology team to decide on treatments that align with your needs and goals.

Join the Conversation

On MyProstateCancerTeam, people share their experiences with prostate cancer, get advice, and find support from others who understand.

Have you been diagnosed with BPH? Let others know in the comments below.