Guide for Prostate Biopsy

Don't panic if your doctor recommends prostate biopsy, especially if your are over 50. The rational for this decision is based on the results of PSA (Protein Specific Antigen) test. It doesn't mean that you have prostate cancer. It simply means that your doctor wants to learn more about your prostate health. It would be nice if the results of a single PSA test was more definitive, but it's not. Anyone of these symptoms might have influenced PSA testing…

• Result of DRE (Digital Rectal Examination)
• Difficult or painful urinating
• Inability to empty bladder completely
• Wanting to urinate several time during the night
• Difficulty starting and ending urination

Reason For Prostate Biopsy

The reason for prostate biopsy is not so clear-cut. But it is base almost entirely on the PSA score, which has its limitations. PSA test may detect small tumors that are unlikely to become life threatening.

A PSA test can produce false positive result. Meaning, that PSA level is elevated, but there is no cancer present. This can lead to unnecessary procedures, that will expose you to unnecessary risk, anxiety, and excessive financial stress. Studies show that less than one third of all men who have undergone prostate biopsy, actually had prostate cancer.

A PSA test can also produce false negative result. Meaning, that PSA level is within range, but there is cancer present. Prostate cancers grow very slowly, and it may take years before they become large enough to cause problems. Hence, males over 70 may undertake significant risk by treating a disease that will not be life threatening during their lifetime.

Prostate biopsy is a procedure use to diagnose prostate cancer. Small pieces of tissue are removed from the prostate gland, and studied under a microscope in order to detect abnormalities. There are two factors that will determine prostate biopsy…

• Elevated PSA level
• Abnormal DRE (irregular size, shape, and texture)

Abnormal findings may just be the result of normal aging, since the prostate increase in size as you get older. Or, they may indicate enlarged prostate, infection, presence of tumors, which could be benign or cancerous.

New thinking postulates that a reduced PSA level is not sufficent to rule out cancer. A urologist told me recently, that a reduced PSA score may not necessarily rule out an increased PSA level. So I ask him to be more specific. That's when he explained the new reasoning: A PSA score that fluctuates within range is also a good reason for prostate biopsy.

How Prostate Biopsy is Performed

Prostate biopsy is a rather simple procedure that is performed in the doctors office. You may be given a mild sedative to induce relaxation. It is unlikely that you will receive an anesthetic. There should be minor discomfort during the procedure.

The urologist will insert a probe containing an ultrasound transducer, which detects and releases high frequency sound waves. While the probe in inside the rectum, you will feel pressure similar to that experience before a bowel movement. The sound wave will bounce off the prostate, and the reflective waves will be detected by the transducer. The computer will convert the waves into black and white images known as a sonograms that will be seen on a monitor. The sonograms will show the exact location of the prostate.

The next step is the removal of the ultrasound probe, and replace it with much smaller one equipped with a needle guide. The probe will simplify the task of positioning the needle guide. The urologist will then activate the guide, which will enter and exit the prostate, collecting slices of tissue into hollow spring-loaded needles. Six to twelve samples, taken from several different areas of the prostate, would be sufficent to indicate how widespread suspicious cells, if any, are.

You should feel a slight pain each time the needle stabs the prostate. But since the action happens so quickly, discomfort should only be minimal. The urologist will remove the ultrasound probe and needle guide from the rectum after collecting the samples.

After the procedure, you may notice blood in semen, stool, and urine for up to two months. The urologist will prescribe antibotics to control any prostate infection that may develop following prostate biopsy.

Avoid having sexual intercourse to prevent further infection. Call your doctor if you develop a fever, experience pain, or notice excessive bleeding or clotting. Learn more about prostate cancer

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