Prostate Biopsy – What Should You Know About It?

Prostate cancer grows and spreads slowly therefore symptoms are likely to appear in the advanced or metastatic stage of cancer. Early diagnosis of prostate cancer can prevent it from spreading to the nearby organs and for this purpose biopsies are done.

Procedure Of A Biopsy

The procedure involves a rectal insertion of an ultrasound probe to get a clear image of the prostate gland. By means of a spring-loaded tool, the doctor collects several samples from different areas of the prostate. Through prostate biopsy, the doctor successfully collects about 10-12 core samples, 5-6 from the either sides. If in certain cases the doctor requires the collection of larger samples, he may perform saturation biopsy which yields up to 20-30 samples. The procedure lasts for about 20 minutes after which the doctor may recommend antibiotics to the patient in order to minimize the risk of infection.

The doctor may also perform trans-perineal biopsy in which a small cut is made between the scrotum and the anus. The needle is inserted through this cut into the prostate for the extraction of sample tissue.

Preparation For Prostate Biopsy

The doctor may recommend doing the following before the appointment of a biopsy procedure:

• Stopping the intake of any medication that is likely to increase bleeding. These medications include; aspirin, warfarin and ibuprofen.
• Being tested for urinary tract infection by submitting a urine sample. In the presence of infection, the biopsy is usually postponed.

• Taking the antibiotic prescribed by the doctor before the prostate biopsy procedure.

The procedure is usually carried out under anesthesia; nevertheless, the person may feel mild-moderate discomfort. Experiencing severe pain during biopsy is usually rare.

Complications Associated With The Procedure

Since it is an invasive approach, it is safe to assume that there are certain risks associated with the procedure. The common complications are bleeding and infection. Others may include:

• Blood in urine or semen
• Difficult urination
• Discomfort and aggravating pain
• Fever

Other Diagnostic Tests For Detecting Prostate Cancer

A prior screening test helps determine the need of carrying out biopsy in most cases. The two common screening tests are:

• DIGITAL RECTAL EXAM (DRE): This procedure involves insertion of the gloved, lubricated finger of the doctor into the rectum for examining the prostate. The doctor may assess parameters like; abnormal texture, shape or size.
• PROSTATE-SPECIFIC ANTIGEN TEST (PSA): This procedure involves collection of blood sample from the vein that runs in the arm. Prostate is responsible for the production of PSA therefore low levels might not ring the alarm bell however high levels may be a red flag for inflammation, infection or even cancer.

After the biopsy is successfully performed, the results along with other influencing factors will let the doctor determine how aggressive the cancer is and what will be the most appropriate treatment approach. Therefore, it is safe to say that the outlook usually depends upon the biopsy results. Factors that may affect the outlook include:

• Cancer stage
• Whether cancer has metastasized
• The grade determined using Gleason core
• Age and overall health condition of the person

References

• Loeb, S., Vellekoop, A., Ahmed, H. U., Catto, J., Emberton, M., Nam, R., ... & Lotan, Y. (2013). Systematic review of complications of prostate biopsy. European urology, 64(6), 876-892.
• Ehdaie, B., Vertosick, E., Spaliviero, M., Giallo-Uvino, A., Taur, Y., O'sullivan, M., ... & Touijer, K. (2014). The impact of repeat biopsies on infectious complications in men with prostate cancer on active surveillance. The Journal of urology, 191(3), 660-664.