Prostate enlargement and prostate cancer are both diseases that older men are prone to, and both diseases increase the size of the prostate 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. Rectal examination: Prostatic hyperplasia has an enlarged gland, but the surface is smooth, the texture is more uniform, the hardness is moderate, and the surrounding boundary is clear; prostate cancer rectal examination can reveal an unevenly enlarged prostate, the surface is uneven, the texture is hard, and nodules can be palpated. 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 usually 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 and 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. Patients with prostate cancer, especially when bone metastases occur, often have elevated serum alkaline phosphatase, while those with prostate enlargement do not.