Benign prostatic hyperplasia vs Prostate cancer
How to tell Benign prostatic hyperplasia and Prostate cancer apart when a board question makes them look alike.
BPH is smooth transition-zone obstruction; prostate cancer is hard peripheral-zone malignancy with metastatic potential.
Side by side
Lower urinary tract obstruction with hesitancy, weak stream, nocturia, and smooth symmetric periurethral enlargement.
Peripheral-zone malignancy with hard irregular posterior nodule, elevated PSA, or osteoblastic bone metastases.
Androgen-sensitive hyperplasia in the transition zone compresses the urethra.
Malignant glandular cells arise most often in the posterior peripheral zone and can spread to bone.
Smooth enlarged prostate, transition-zone growth, and obstructive urinary symptoms support BPH.
Hard nodule on rectal exam, rising PSA, peripheral-zone lesion, or osteoblastic metastases support prostate cancer.
The trap
Both can cause urinary symptoms and PSA elevation, so exam texture, zone, and metastasis clues matter.
The repair move
For prostate questions, separate transition-zone obstruction from peripheral-zone cancer.
Try a free question
CoreA 68-year-old has urinary hesitancy, weak stream, nocturia, and a smooth symmetrically enlarged prostate on rectal exam. Which diagnosis is most likely?
Show answer and explanation
Answer: A. Benign prostatic hyperplasia. BPH arises in the periurethral transition zone and causes lower urinary tract obstruction with smooth enlargement.
Why the other choices are tempting
- B. Prostate cancer classically arises in the peripheral zone and may produce a hard irregular nodule.
- C. Acute prostatitis causes fever, dysuria, pelvic pain, and tender boggy prostate.
- D. Bladder cancer usually presents with painless hematuria.
- E. Urethral stricture can obstruct flow but does not cause symmetric prostate enlargement.
Flashcards
Tap a card to flip it.
What prostate zone is classic for BPH?
BPH arises in the periurethral transition zone and compresses the urethra.
What prostate zone is classic for prostate cancer?
Prostate cancer most often arises in the posterior peripheral zone.
Quick answers
What is the fastest way to tell Benign prostatic hyperplasia from Prostate cancer?
BPH is smooth transition-zone obstruction; prostate cancer is hard peripheral-zone malignancy with metastatic potential.
What is the key clue for Benign prostatic hyperplasia?
Lower urinary tract obstruction with hesitancy, weak stream, nocturia, and smooth symmetric periurethral enlargement.
What is the key clue for Prostate cancer?
Peripheral-zone malignancy with hard irregular posterior nodule, elevated PSA, or osteoblastic bone metastases.
What is the common trap with Benign prostatic hyperplasia vs Prostate cancer?
Both can cause urinary symptoms and PSA elevation, so exam texture, zone, and metastasis clues matter.