Prostate cancer diagnosis

Often requires a prostate biopsy

 A prostate cancer diagnosis is commonly confirmed by a prostate biopsy (also called a core needle biopsy), which is a procedure that is usually done in the doctor’s office. It is often performed by a urologist, a surgeon who treats prostate cancer.

Expect to have about 12 core samples taken from different areas of the prostate gland. A doctor may take more core samples to confirm a diagnosis. This helps ensure that if cancer is present, the doctor will find it.


Before a prostate biopsy

Your loved one’s doctor will tell him how he needs to prepare prior to his biopsy, such as:

  • Taking an antibiotic to prevent the possibility of infection
  • Stop taking blood thinners or other medications prior to the procedure

During the procedure

A prostate biopsy is guided by transrectal ultrasound or (TRUS). This special machine helps the doctor know where to insert the needle to get the desired tissue samples.

Here's what happens:

  •  A small probe is placed inside the rectum
  • It picks up echo patterns after it emits sound waves that travel into the prostate
  • A computer uses the echo patterns to help determine areas where there may be a tumor
  • A needle is inserted into a special device
  • Small pieces of tissue are quickly removed from several areas in the prostate gland (from 8 to 18 times)
  • The samples are examined under a microscope by a specialist doctor who diagnoses disease in tissue samples (called a pathologist)

Another approach is to do a needle biopsy through a small incision in the skin between the rectum and the scrotum (called the skin of the perineum).

A prostate biopsy usually only takes about 10 minutes, but you will probably have to sit in the waiting room much longer than that.

There may be discomfort

A man will probably feel:

  • Some level of pressure or discomfort when the probe is inserted
  • Short jabs of pain when the core samples are taken

The doctor may use an anesthetic to numb the area (you can ask about this ahead of time).  As soon as the anesthetic wears off, your loved one may feel some discomfort during the ride home and soreness for a few days.

It is not uncommon to notice blood in the urine, or bleeding during bowel movements for a few days (particularly if a man has hemorrhoids).  There may also be some blood in the semen for up to several weeks.  If the bleeding continues, or your loved one is concerned about the amount of blood, definitely contact his doctor.

You should call the doctor immediately if you notice any signs of:

  • Fatigue
  • Fever
  • Infection
  • Difficulty urinating


Waiting can be nerve racking

It may take several days to get the results so try to put it out of your mind as best you can.  A prostate cancer diagnosis is confirmed if cancer is present in any of the core samples. The pathologist's report will tell you:

  • How many core samples were positive for prostate cancer
  • What percentage of cancer was in the core sample(s)
  • Whether cancer is present on one side of the prostate gland or on both sides (called bilateral)

Unfortunately a prostate biopsy is not a foolproof method for prostate cancer diagnosis. Some areas with cancer may be missed if a needle does not pass through them. If cancer is still suspected, the biopsy may be repeated to get a prostate cancer diagnosis.

Next: Gleason score

What are the causes?
Symptoms
PSA testing
Digital rectal exam
Staging
Advanced cancer
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Always consult a medical professional.

References:
The American Cancer Society. Prostate Cancer. http://www.cancer.org. Accessed March 17, 2015.

American Urological Association. The Management of Localized Prostate Cancer. http://www.auanet.org. Accessed September 1, 2008.

Bostwick DG, Crawford DE, Higano CS, Roach M, eds. American Cancer Society’s Complete Guide to Prostate Cancer. Atlanta, GA: American Cancer Society Health Promotions; 2005

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