Prostate Biopsia

Prostate Biopsia

Prostate Biopsia

Prostate biopsies are widely used to diagnose prostate cancer. However, the procedure can be painful and stressful and does not always reach an accurate diagnosis.Despite this, more than a million people have prostate biopsies in the United States each year. Of these, only 20% receive a diagnosis of prostate cancer.

While prostate biopsies can be medically useful, they can cause unnecessary worry and prompt unnecessary treatment if prostate cancer is not present. Many people do not need active treatment for early signs of prostate cancer.

A biopsy is not the only reliable option for assessing risk for prostate cancer, deciding on further screening, and testing for prostate cancer without causing unnecessary anxiety.

Alternatives to prostate biopsy and their benefits

sPeople should discuss with their urologists whether a prostate biopsy is suitable or an alternative may be better. A biopsy may be the best option when:

  • Levels of prostate specific antigen (PSA) are high or significantly higher than the size of the prostate suggests.

  • Imaging of the prostate suggests an aggressive form of cancer may be present.

  • A patient has a high risk of prostate cancer.

Alternatives:

Prostate cancer enzyme tests

To determine if prostate cancer is present and how aggressive or fast-growing it is, some tests look for enzymes produced by prostate cancer. These tests use either blood or urine samples to determine a person’s overall risk for prostate cancer.

Urologists usually recommend these tests for males who have high PSA scores or whose they found abnormalities during a digital prostate exam.

A newer blood test is the 4Kscore test, which measures a person’s risk of prostate cancer.

The test does not completely replace a biopsy, but it can help determine who needs one. This can help doctors reduce the number of people who have biopsies.

For testing African American and Afro Caribbean men for prostate cancer.The 4Kscore test is also effective

Enzyme tests cannot identify every case of prostate cancer, but neither do biopsies. Instead, blood and urine screenings can identify the most aggressive presentations of the cancer.

Some forms of prostate cancer are slow growing rather than aggressive. Slow growing prostate cancer is unlikely to be fatal.

Watchful waiting

Urologists normally recommend a prostate biopsy due to a high PSA score. However, other health issues can contribute to an elevated PSA score. A PSA score also tends to increase with age.

Waiting and testing PSA levels again can be helpful. Prostate cancer may not be present if a PSA score remains high but does not change since the last test.

MRI scan

An MRI scan uses a magnetic field and radiofrequency pulses to produce a clear image of the prostate.

As biopsies, MRIs can sometimes produce an incorrect result. However, they are less invasive and still give an accurate guide to prostate cancer risk.

Doctors use a variety of MRI techniques to look for prostate cancer, including:

  • Diffusion weighted imaging: This examines how the prostate absorbs water.

  • Using contrast imaging, the doctor observes blood flow in and around the prostate.

  • Spectroscopic imaging: This aims to distinguish prostate cancer from other causes of prostate enlargement, such as infection.

Each technique has strengths, weaknesses, and a variable ability to detect a type of prostate cancer. The most effective MRI methods combine several of these imaging techniques.

Biopsy overview

For most men, testing for prostate cancer includes a blood test for PSA. Higher-than-normal PSA scores may suggest a problem with the prostate.

If a PSA test or a digital rectal exam of the prostate shows a possible irregularity, a doctor may recommend further testing, such as a biopsy.

During the biopsy, a doctor uses an ultrasound device to look at the prostate. They insert a small device into the rectum to perform the ultrasound.

Using a small, hollow needle, the urologist removes a tissue sample from the prostate. They send this to a laboratory where a pathologist views the sample under a microscope to check for abnormal cell growth.

The biopsy may involve collection of several samples of prostate tissue during the procedure.

A prostate biopsy can also help a urologist decide the stage of any cancer that is present. Knowing whether cancer is advanced or aggressive can help a doctor determine the best treatment.

It will also help them decide whether treatment is necessary. For many men with low stage or slow growing prostate cancer, watchful waiting may be the best course of action.

Benefits and risks of prostate biopsy

A prostate biopsy is a standard procedure. Benefits of choosing this option include:

  • getting accurate information about how aggressive the cancer is

  • confirming a diagnosis of suspected prostate cancer

  • enabling prompt treatment of prostate cancer

If diagnosis and treatment remove prostate cancer before it spreads to distant organs, the 5 year survival rate is almost 100%

This means that a person with prostate cancer is nearly 100% as likely to survive for 5 years beyond diagnosis as a person who does not have prostate cancer.

The disadvantages of a prostate biopsy include:

  • Discomfort: Most people receive pain medication to reduce discomfort during the procedure. However, it is common to experience bleeding and pain in the days following a prostate biopsy.

  • Inaccurate results: Prostate biopsies miss about 20% of cancers. They can also produce false-positive results. This means some people may need to have multiple biopsies.

  • It could occurs infection and other prostate issues and it will be necessary hospitalization