A look at the Prostate Cancer Biopsy Procedure

If the results of your preliminary prostate cancer screening tests such as those from a digital rectum exam or a PSA test suggest that you may be at risk from prostate cancer then it will be necessary to carry out more intrinsic tests, one of the most commonly used methods is that of a prostate biopsy.

In a biopsy for prostate cancer a sample of the prostate is removed so that it can undergo deeper histological analysis in the lab by a pathologist; the sample of prostate is usually removed by use of a needle or by surgery. After examining the tissue the pathologist will send the results to your doctor, the results will usually include pictures of the tissue and your Gleason Scores.

As cancer may be isolated to specific parts of the prostate it is necessary to remove many tissue samples during the biopsy, typically 6 (sextent) to 12 samples are needed, but sometimes as many as 20 samples may be required (if there is a high chance of the patient having cancer). Samples from each side of the prostate, at the top, bottom and middle are taken during the biopsy. The doctor is able to locate the prostate biopsy needle by use of transrectal ultrasound.

Core Needle Biopsy

Usually a prostate cancer biopsy is carried out using a technique called core needle biopsy; there are two main types of core needle biopsy, namely transrectal biopsy and perineal biopsy. In the latter technique the doctor will feel for the prostate by placing his finger up the rectum, and enter a needle via the perineum to take a sample; this technique is largely redundant nowadays due to the advancement of ultrasound technology. A prostate biopsy will not lead to impotence nor to infertility.

The most commonly carried out type of core needle biopsy is that of transrectal biopsy. In this technique a doctor will guide the biopsy needle by use of an ultrasound probe (the ultrasound enables the doctor to see an image of the prostate and take samples accurately). The prostate tissue is removed by use of a small needle that is automatically fired from the ultrasound probe/gun head.

Patient experience during a transrectal biopsy

A core needle transrectal biopsy usually takes about fifteen minutes to perform. Before the procedure the doctor may put you on a small course of antibiotics and ask you not to take anticoagulants if you are on them. The transrectal biopsy experience itself is usually uncomfortable as the the ultrasound probe will give pressure to the rectum, and the taking of the samples will result in a short quick pain. The surgeon will usually lower the pain levels by inserting anaesthetic jelly into the rectum or by giving an anaesthetic injection through the wall of the rectum.

Following the prostate biopsy

It is important that the patient rests following a prostate biopsy for around two and a half hours; during this time the doctor/nurse will take blood pressure readings to ascertain that everything is well. It is recommended that the patient takes it easy during the rest of the day.

It is common for a patient to feel discomfort in the area of the prostate for a couple of days and for blood to be seen in the urine and following a bowel movement for up to a week. Blood may also be seen in the semen for up to one month.

It is necessary to contact the doctor if any of the following occur: Excessive bleeding, excessive fatigue, a high temperature, inability to urinate, increased pain.