Prostatitis vs Prostate Cancer
Prostate cancer and prostatitis are conditions that are unique to males because females do not have a prostate. Prostate symptoms are common in the elderly, and it is important to differentiate between the two because one is a simple condition while the other is a very serious condition. This article will talk about both prostate cancer and prostatitis and the differences between them in detail highlighting their clinical features, symptoms, causes, tests and investigation, and also the course of treatment/management they require.
Prostate cancers occur in the elderly individuals. All cancers including prostate cancers are thought to have a common mechanism of origin. Cancers are thought to be due to abnormal genetic signaling which promote uncontrolled cell division. There are genes called proto-oncogene, with a simple alteration, which can be cancer causing. Mechanisms of these alterations are not clearly understood. Two hit hypothesis is an example of such a mechanism. They present with obstructive urinary symptoms such as difficulty to start a urine stream, poor urine stream, and prolonged dribbling after urination. Many cases are detected incidentally during a digital rectal examination. During digital rectal examination, the prostate feels lumpy, enlarged without the median groove.
Prostate cancers are slow growing mostly. Once detected, prostate specific antigen, ultrasound scan of the pelvis (trans-rectal) may be performed. Sometimes a CT scan or MRI may be needed to assess the spread. Biopsy of suspicious lesions is an option. If detected, transurethral resection of prostate or open surgery is the available treatment options. Post-surgically, radiotherapy and chemotherapy also play a role. Because prostate cancer is testosterone sensitive, bilateral orchiectomy is also an option for advanced disease.
Prostatitis is the inflammation of the prostate. There are 5 types of prostatic inflammation. They are acute prostatitis, chronic bacterial prostatitis, inflammatory chronic prostatitis / chronic pelvic pain syndrome, non-inflammatory chronic prostatitis / chronic pelvic pain syndrome, and asymptomatic inflammatory prostatitis. Acute prostatitis presents with pelvic / lower abdominal pain, fever, pain while urination, and frequent urination. There are bacteria in urine and a raised white cell count. Chronic bacterial prostatitis may or may not have pain, but urine contains bacteria and the white cell count is raised. Inflammatory chronic prostatitis / chronic pelvic pain syndrome presents with pelvic pain and a raise white blood cell count in full blood count. Non-inflammatory chronic prostatitis / chronic pelvic pain syndrome presents with pain, but there are no bacteria in urine or a raised white blood cell count. Asymptomatic inflammatory prostatitis is an incidental finding where there are white blood cells in semen.
What is the difference between Prostate Cancer and Prostatitis?
• Prostate cancer is a serious condition while prostatitis is not.
• Prostate cancers are common in the elderly while prostatitis is more common during the middle ages and late middle ages.
• Prostatic cancer needs excision, chemotherapy and radiotherapy while anti-inflammatory drugs and antibiotics will cure prostatitis.
• Prostatitis does not need surgical removal of the prostate.
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