The Prostate Biopsy

Image courtesy of David Castillo at FreeDigitalPhotos.net

For men 50 and over, digital rectal exams, or DREs, has become a routine part of the annual checkup, as have prostate specific antigen, or PSA tests. These tests can uncover signs of prostate cancer. But before a doctor can make the final diagnosis, they will use an another procedure: the prostate biopsy. To confirm the presence of prostate cancer, a doctor uses a needle to collect a sample of cells from the prostate. A pathologist, an expert who can distinguish cancerous from non-cancerous cells, then examines this sample. With more and more men undergoing biopsies, doctors are making every effort to ensure the procedure is as safe, comfortable, and accurate as possible.

A prostate biopsy is a very simple procedure. The whole process takes about 15 minutes and doesn’t require anesthesia. The doctor will insert a slender ultrasound device into the patient’s rectum, and the device will emit sound waves to produce an image of the prostate. The process is referred to as transrectal ultrasound or TRUS. Guided by the ultrasound image, the doctor will slide a tiny needle through the rectal wall and into the prostate gland. The important word here is tiny, a prostate biopsy needles are only 1.2 millimeters in diameter.

Prostate tumors tend to be extremely small and can be located about anywhere on the prostate. Due to this reason, doctors take samples from several areas of the prostate gland. The most common approach is to take six different samples. However, in some cases, doctors will take as many as 47 samples in a search for cancer. This approach can uncover tumors that regular biopsies might miss. The comprehensive procedure requires that the patients be anesthetized first.

There are few side affects to biopsy. In most cases, fear of the biopsy causes more trouble than the actual biopsy. Many patients might notice small amounts of blood in their stools, urine, or semen in the days after a biopsy. This is normal and to be expected and no cause for alarm. Less than 1 percent of all patients develop severe bleeding or an infection of the prostate or urinary tract due to biopsy. Whether a surgeon takes several biopsy samples, or dozens or more, there’s still a chance that the cancer will be missed. In one study researchers performed biopsies on 800 men who had recently had negative biopsies. In ten percent of the cases, the second biopsies turned up cancer. So a negative biopsy is no guarantee that you are truly cancer-free. Even if you don’t show any signs of cancer, continue to get regular PSA tests and digital rectal exams as recommended by your doctor.