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.