Prostatitis vs. Prostate Cancer

Medically Reviewed by Nazia Q Bandukwala, DO on May 10, 2022
6 min read

Your prostate is an organ that makes some of the fluid that’s part of semen. It’s below your bladder and in front of your rectum. Prostate cancer happens when the cells in your prostate gland grow out of control. Prostatitis, on the other hand, is a different condition that affects your prostate gland. It’s usually not as serious.

If you have prostatitis, you might have an infection, inflammation, or pain. Prostatitis is a benign condition, while prostate cancer is malignant. But there are some symptoms that overlap between the two conditions.

Prostatitis is a fairly common urinary tract issue. Besides skin cancer, prostate cancer is the most diagnosed form of cancer in the United States.

Prostate cancer and prostatitis may have some similar symptoms, like:

  • A lower force in your stream of pee
  • Blood in your semen
  • Erectile dysfunction

Other symptoms may be different between the two conditions. There are four types of prostatitis:

Acute bacterial prostatitis (ABP). This happens when a urinary tract infection (UTI) causes an infection in your prostate gland. You may notice symptoms like fever, chills, needing to pee often, or a hard time when you pee. If you have this type of prostatitis, you need medical treatment right away.

Chronic bacterial prostatitis (CBP). Bacteria will become trapped in your prostate gland. This causes recurrent UTIs that can be hard to treat.

Chronic pelvic pain syndrome (CPPS). Doctors also call this CPS. It’s the most common type of prostatitis. It causes chronic pain in your pelvis, perineum (which is the area between your scrotum and rectum), and your genitals.

Asymptomatic inflammatory prostatitis. This causes prostate gland inflammation but has no symptoms. This form doesn’t need treatment. You may find out you have it after you get tests for other conditions. You may get, for example, a semen test for infertility. This test could detect asymptomatic inflammatory prostatitis.

If you have chronic pelvic pain syndrome (CPPS) or chronic bacterial prostatitis (CBP), you might notice:

  • Pain in your penis, testicles, or perineum (the area between your testicles and rectum). This pain might move to your lower back.
  • An urge to pee a lot
  • A painful feeling when you pee
  • Pain when you ejaculate or during sex

Prostate cancer may cause different symptoms. Sometimes, it causes no signs or symptoms at all in the early stages. If your cancer is more advanced, it may cause:

  • Trouble peeing
  • Blood in your pee
  • Weight loss
  • Bone pain
  • Erectile dysfunction

The cause of prostatitis is not always known. You can raise your risk of getting it with a bacterial infection or bladder infection, a catheter, an infection from sex, or a problem in the urinary tract. Your doctor may have to do several tests to find out exactly why you feel pain. But it is important to find out what may have caused it.

Bacterial prostatitis happens when bacteria get into your prostate. Bacteria can be found in your pee, prostate fluid, or blood. Your sex partner cannot catch this type of infection.

Nonbacterial prostatitis may be linked to irritation, nerve damage, or stress. It could also happen if your body reacts to an injury or infection you had in the past. This form has no signs of bacteria in your pee or prostate fluid.

Causes for bacterial forms of prostatitis might include:

  • Bladder stones or bladder infections
  • Surgery or a biopsy that requires a urinary catheter
  • Prostate stones
  • Prostate abscesses
  • Urinary retention (which means you don’t empty your bladder completely)
  • Urinary tract infections (UTIs)
  • Benign prostatic hyperplasia (BPH), a common condition where your prostate gets bigger as you age
  • Catheters

There’s also no clear cause of prostate cancer. But doctors know that it begins when DNA in your prostate cells change. These changes tell your cells to grow and divide quicker than normal cells.

There are some risk factors for prostate cancer. They include:

Older age. As you get older, your risk of prostate cancer goes up. It’s especially common after the age of 50.

Family history. If a relative, like a parent, child, or sibling, has prostate cancer, you might have a higher chance of the condition. You may also be at risk of prostate cancer if you have a strong family history of breast cancer or a family history of genes that heighten the risk of breast cancer (called BRCA1 or BRCA2).

Race. Experts don’t know why, but if you’re Black, you have a higher risk of prostate cancer than people of other races. If you’re Black, you’re also more likely to have aggressive or advanced forms of prostate cancer.

Obesity. Compared to people at a healthy weight, people with obesity might have a higher risk of prostate cancer. But studies have shown mixed findings. Obesity may also cause prostate cancer to be more severe and return even after treatment.

Digital rectal exam (DRE). For both conditions, your doctor may perform this exam. They’ll use a glove and lubricant to insert their finger into your rectum. Your doctor can examine your prostate this way. If they notice any abnormal features in the texture, shape, or size of your prostate, they might suggest more tests.

Blood tests. They also may do blood tests for either prostate cancer or prostatitis. These measure prostate specific antigen (PSA), a natural substance that your prostate makes. High levels might mean that you have prostatitis, prostate cancer, or benign prostatic hyperplasia (BPH).

If you are at risk for cancer, your health care provider may order a blood test to check your PSA level. But if you have a prostate infection, your PSA can be falsely raised. Because of this, doctors are careful about how they read your PSA test results

For prostatitis, your doctor will ask about your symptoms and do a physical exam on you to check for prostatitis. They may also do a few different tests. These might include:

Urinalysis. This test checks your pee for bacteria and UTIs.

Cystoscopy. A cystoscopy looks for other urinary tract issues. It can’t diagnose prostatitis, but it can help find what other things may cause your symptoms. Your doctor will use a cystoscope (which is a pencil-sized tube with a light and camera or viewing lens) to look inside your urethra and bladder.

Transrectal ultrasound. If you have acute bacterial prostatitis or chronic bacterial prostatitis that doesn't get better with antibiotics, you might need a transrectal ultrasound. This is a small ultrasound probe that your doctor will put in your rectum. It uses sound waves to create images of your prostate gland. This test can show your doctor if you have prostate gland issues.

If these tests show anything abnormal, your doctor might want you to get further tests to tell if you have prostate cancer. These may include ultrasounds, magnetic resonance imaging tests (MRIs), or prostate tissue tests.

Prostatitis treatment varies based on the type you have.

If you have asymptomatic inflammatory prostatitis, you don’t need treatment.

With CPPS, your doctor might use something called UPOINT. This helps them classify your symptoms into six groups: urinary, psychosocial, organ, infection, neurologic, and tenderness factors. They’ll then use various treatments together to treat your specific symptoms.

For bacterial versions of prostatitis, you may need antibiotics. In rare cases, you may need surgery to drain your prostate.

Treatment for prostate cancer is also based on different factors. It depends on how much your cancer has spread, how fast it’s spread, your overall health, and the possible side effects of treatment. Your doctor might suggest: