Prostate hypertrophy and total prostate-specific antigen 21 may be prostate cancer, but other factors are not excluded, and the specific situation varies from person to person. The causes of prostate hypertrophy include the role of androgens hosting their receptors, imbalance between cell proliferation and apoptosis, the role of growth factor neurotransmitters, prostate mesenchymal gland epithelial interactions, and inflammatory factors. Total prostate-specific antigen is a tumor marker for the detection of prostate cancer, and the level is usually 0-4ng/L in normal people. Total prostate-specific antigen 21ng/L is relatively high, and elevated values are often associated with urinary tract obstruction, prostate hyperplasia, prostate cancer and other diseases. Rectal examination, cystoscopy and other procedures may also affect the total prostate-specific antigen value. In case of prostate enlargement and Total Prostate Specific Antigen 21, it is recommended to undergo further comprehensive examination in regular hospitals and relevant treatment under the guidance of urology specialists.