Prostate cancer differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Prostate cancer must be differentiated from benign prostatic hypertrophy, renal cancer, renal stones, bladder cancer, and cystitis.
Differential diagnosis
Prostate cancer must be differentiated from:
- Benign prostatic hypertrophy (BPH)
- Renal cancer
- Renal stones
- Bladder cancer
- Cystitis
- Glomerulonephritis
- Prostatitis
- Pyelonephritis
Benign prostatic hypertrophy
- The main difference between BPH and prostate cancer is that even though the prostate gland is enlarged in both, in BPH it is a benign or noncancerous condition[1]
- BPH is very common especially as a man ages and his prostate begins to grow. When this happens, it puts pressure on the urethra resulting in the following symptoms:
- An urgent need to urinate
- Having the need to urinate many times during the day and night
- Hesitancy or troubling starting a urine flow
- Weak or dribbling urine stream
- Digital rectal exam and elevated blood test called prostate specific antigen or PSA, can confirm if it might be BPH.
- BPH does not cause prostate cancer and unlike prostate cancer, it cannot spread to other areas of the body.
Renal Cancer
- Renal cell carcinoma doesn’t usually cause any symptoms[2]
- As the disease gets more serious, you might have warning signs like:
- Lump on your side, belly, or lower back
- Blood in your pee
- Low back pain on one side
- Losing weight for no clear reason
- Not feeling hungry
- Fever
- Feeling tired
- Not enough red blood cells (anemia)
- Night sweats
- High levels of calcium in your blood
- High blood pressure
Renal Stones
- Kidney stone usually remains symptomless until it moves into the ureter[3]
- When symptoms of kidney stones become apparent, they commonly include:
- Severe pain in the groin and/or side
- Blood in urine
- Vomiting and nausea
- White blood cells or pus in the urine
- Reduced amount of urine excreted
- Burning sensation during urination
- Persistent urge to urinate
- Fever and chills if there is an infection
Bladder Cancer
- Bladder cancer is often painless[4]
- The most significant sign of a malignancy is urinary bleeding, either overt (known as gross hematuria) or detected with blood or imaging tests (microscopic hematuria).
- The bleeding may be consistent or intermittent.
- While blood in urine may be distressing, it is neither diagnostic of cancer nor predictive of the severity of a malignancy.
- The signs and symptoms of bladder cancer can vary based on the size and location of the tumor as well as the stage of the disease.
- In addition to bleeding, other symptoms may include:
- A persistent urge to urinate (urinary urgency)
- Frequent urination (urinary frequency)
- Back or abdominal pain
- Loss of appetite
- Unexplained weight loss
Cystitis
- Cystitis refers to an inflammation of the bladder, in most cases caused when upward moving bowel bacteria invades the bladder and begins to grow[5]
- The following are common signs and symptoms of cystitis:
- Traces of blood in the urine
- Dark, cloudy, or strong-smelling urine
- Pain just above the pubic bone, in the lower back, or in the abdomen
- burning sensation when urinating
- Urinating frequently or feeling the need to urinate frequently
- Elderly individuals may feel weak and feverish but have none of the other symptoms mentioned above.
- They may also present with altered mental status.
- There is a frequent need to urinate, but only small amounts of urine are passed each time.
References
- ↑ Chang RT, Kirby R, Challacombe BJ (April 2012). "Is there a link between BPH and prostate cancer?". Practitioner. 256 (1750): 13–6, 2. PMID 22792684.
- ↑ Barocas DA, Rabbani F, Scherr DS, Vaughan ED (January 2006). "A population-based study of renal cell carcinoma and prostate cancer in the same patients". BJU Int. 97 (1): 33–6. doi:10.1111/j.1464-410X.2005.05880.x. PMID 16336324.
- ↑ Chung SD, Liu SP, Lin HC (2013). "Association between prostate cancer and urinary calculi: a population-based study". PLoS ONE. 8 (2): e57743. doi:10.1371/journal.pone.0057743. PMC 3581486. PMID 23451265.
- ↑ Rom M, Kuehhas FE, Djavan B (2007). "New findings in bladder and prostate cancer: highlights of the 22nd annual congress of the European association of urology, march 21-24, 2007, berlin, Germany". Rev Urol. 9 (4): 214–9. PMC 2199502. PMID 18231618.
- ↑ Fan CY, Huang WY, Lin KT, Lin CS, Chao HL, Yang JF, Lin CL, Kao CH (2017). "Lower Urinary Tract Infection and Subsequent Risk of Prostate Cancer: A Nationwide Population-Based Cohort Study". PLoS ONE. 12 (1): e0168254. doi:10.1371/journal.pone.0168254. PMC 5207623. PMID 28046120.