Prostate enlargement and prostate cancer are both diseases that older men are prone to, and both diseases can increase the size of the prostate gland and cause difficulty in urination due to pressure on the urethra. The main differences are as follows: 1. Course of disease: Prostate enlargement is slow in onset and progresses slowly; prostate cancer is relatively rapid in onset and development, especially after the onset of symptoms, and the course of the disease develops quickly. 2. Rectal examination: the enlarged prostate gland has a smooth surface with a more even texture, moderate hardness and clear boundaries around it; the rectal examination of prostate cancer can reveal an unevenly enlarged prostate gland with an uneven surface, hard texture and palpable nodules. Ultrasound examination: Prostate enlargement can be seen as an increase in volume with uniform or less uniform echogenicity. Prostate cancer can be seen as an abnormal strong echogenic or hypoechoic cluster. 4.Serum prostate-specific antigen (TPSA): In prostate hyperplasia, the prostate-specific antigen (TPSA) is generally not elevated; in prostate cancer, the prostate-specific antigen (TPSA) is generally elevated. 5. Biopsy: Pathological examination by puncture of prostate tissue can accurately identify prostate hyperplasia and prostate cancer. 6.Metastasis: Prostate hyperplasia is a benign disease and will not metastasize; while prostate cancer is a malignant disease, metastasis of tumor cells to bones, lymph nodes, lungs and bladder will occur, mostly showing pain in the lumbar spine, pelvis, legs, or enlarged lymph nodes in the groin area, etc. Patients with prostate cancer, especially when bone metastases occur, often have elevated serum alkaline phosphatase, while those with prostate enlargement do not.