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Prostate Biopsy: Frequently Asked Questions

What is a prostate biopsy?

A biopsy is a sample of tissue that is looked at under a microscope for cancer cells. Your urologist can take tissue samples from your prostate right in his or her office. Most of the time, the doctor performs the biopsy by inserting a needle through the perineum into the prostate. The perineum is the area between the rectum and the testicles. The doctor usually uses a rectal ultrasound to help guide the needle into the prostate. To get a good tissue sampling, the doctor takes 6 to 12 needle biopsies at the same time.

How diagnostic is prostate biopsy?

If the examining doctor finds the results of the PSA test or the DRE to be alarming, he will recommend that a biopsy be carried out. Samples of tissue are taken from the prostate in the biopsy and checked for cancerous cells. It is recommended that at least 12 samples of tissue are taken during the biopsy in order to effectively screen for the presence of cancer cells.

Can a Prostate Biopsy Spread Prostate Cancer?

Absolutely! There was a study done (the reference eludes me) that demonstrated a risk of 10-20% for needle tracking of cells along the biopsy path. Patients and physicians should always consider carefully the risks and potential benefits before a prostate biopsy is performed.
No, there is no scientific evidence that shows that biopsies spread cancer.

What is a prostate biopsy and is it painful?

A core needle biopsy is the main method used to diagnose prostate cancer. It takes just a few minutes to perform and may produce some temporary discomfort. In this procedure, a sample of tissue is removed and then examined under a microscope. The doctor inserts several narrow needles (usually through the wall of the rectum) into the prostate gland, using transrectal ultrasound (TRUS) to guide the needles to the prostate. ...

Can the DVS dosimeter be implanted in the prostate with a biopsy needle at the time of biopsy?

The DVS dosimeter should be inserted through the perineum using the DVS insertion tool provided. The instructions for implantation are included in the DVS Instructions for Use and supplemented with a DVS Implantation Demonstration .

When is a Prostate Biopsy needed?

Although an abnormal DRE or an elevated PSA may suggest the presence of prostate cancer, a diagnosis of cancer can only be confirmed by a prostate biopsy. Biopsies are minimally invasive procedures. A small amount of prostate tissue is removed by a needle inserted through the rectum. An ultrasound probe is used to guide the needle. Usually this procedure is performed usually performed as an outpatient procedure without anesthesia. What are treatment methods for prostate cancer? ...

What happens if prostate cancer is found in the biopsy?

If the prostate biopsy finds a cancer, more tests are done to find out whether the cancer has spread and if so, how far. 12 This process is called staging. Staging is very important because your treatment and the outlook for recovery depend on the stage of the cancer. There is more than one system for staging prostate cancer. ...

How should I prepare for Prostate biopsy?

This is done at the Urosurgery Mt. E Clinic at Level 12 unit #12-03 unless instructed otherwise by the doctor. Fasting is not required. Do open your bowel on the morning before the procedure. Do start taking the antibiotic prescribed the night before the procedure. STOP all blood thinning medication such as Aspirin, Cardiprin, Persantin, Plavix or Warfarin, temporarily a week before the treatment. Do continue to take your medication for hypertension before the procedure. ...

What is the value of the sextant approach to prostate biopsy? Is the sextant still the norm?

The routine sextant is the systematic foundation for prostate biopsy. However, because prostate cancer is becoming more difficult to detect many urologists are utilizing strategies outside of the routine sextant biopsy to help locate tumors that might otherwise be missed. In fact, the current literature shows that 8, 10 or 12 core biopsy techniques enhance diagnostic yield and allow urologists to: 1. Significantly increase the likelihood of cancer detection in initial biopsies. ...

Can I get a prostate infection from the biopsy?

You will be given antibiotics to take after the biopsy in order to prevent an infection. Please make sure you take all the doses given. If you experience a fever or difficulty urinating, please contact us even if you have taken the antibiotics.

Q: What is involved in a prostate biopsy?

A prostate needle biopsy is not a pleasant experience, but it is not that bad either because prostate biopsies are now done with local anesthesia. You prepare for it by taking antibiotics by mouth and a Fleets enema before going to the doctor’s office. You lie on your left side and the doctor does a digital rectal examination of the prostate gland and then inserts the ultrasound probe into the rectum. ...

In follow-up care, how can a biopsy be performed if the prostate is no longer there?

The biopsy is conducted on the scar tissue that is left behind. Negative biopsies indicate that cancer is no longer present.

Q: What PSA Velocity* should be used to recommend a prostate biopsy?

This issue is in flux at present. Currently, it is thought that a PSAV between 0.3 and 0.5 should be used to recommend a biopsy In men with a PSA lower than 4. New 2007 guidelines will be issued by the National Comprehensive Cancer Center Network and the American urological Association this year, and I believe they will recommend 0.4 and 0.35, respectively. It looks as if prostate cancer should be diagnosed before the PSA is above 4 and the PSA velocity gets above 0.5. ...

Will it be necessary to biopsy my prostate to see if the cancer has been destroyed?

In the past, biopsies were often required. However, we now know that if the PSA reaches a nadir less than 0.5 and stays there, no biopsy is needed. If the PSA begins to rise and we would consider adding some other therapy or doing something different, only then might it be important to determine if cancer is still present in the prostate.

Does having a prostate ultrasound done mean that I automatically will have a prostate biopsy done?

Having an ultrasound scheduled does not always mean a biopsy will be done. A prostate ultrasound will allow your physician to see images/pictures of your prostate. An ultrasound probe will be placed in your rectum to produces these pictures. This should not be painful though many patients say that they experience great deal of pressure in the rectum. When a prostate biopsy is necessary, it will be done at the same time as the ultrasound.

Q: Does needle biopsy of the prostate spread prostate cancer cells?

Evidence suggests the answer is no. And countless patients have been cured of prostate cancer after having had many needle biopsies.

How does the doctor determine how many samples to take in a prostate biopsy?

Initially, most doctors take six to eight samples. However, it is known that the first biopsy procedure misses the cancer in 20% of patients. Accordingly, in patients who continue to have a rising PSA level or other features that are worrisome for prostate cancer, more biopsies are taken during repeat procedures. The exact number taken depends upon how uncomfortable the patient finds the procedure and may include 15 to 20 samples.

Q: Should a biopsy of the prostate be done at the same time a TURP is performed to relieve symptoms of an enlarged prostate?

I believe that a biopsy should be performed before the procedure, because, if the patient has prostate cancer, the TURP might complicate the subsequent treatment with surgery or radiation.

Can the PCA3 test aid in the decision whether a biopsy is needed in men suspected of having prostate cancer but who have been previously treated for prostatitis?

Reviewed by Prof. B. Tombal - 2008/08/01 Keywords PCA3 Test DRE Diagnosis Biopsy Prostate cancer specific PSA Prostatitis

A14. I have been told I need to check my eligibility for the IMPACT study because of my previous history of raised PSA and/or prostate biopsy. Why is this?

The study team may need to speak to your doctor or look at your medical records to assess whether you are eligible for the study. Please contact your local study team directly to talk through your medical history and talk about taking part in the study.

I am having a prostate biopsy performed. Does someone need to accompany me to drive me home after the procedure?

Yes. We recommend that a friend or family member accompanies you to the office to drive you home after a prostate biopsy. We also discourage travel at any significant distance for 3 days after the biopsy in the event that a complication would arise. Back to top Insurance Related Questions

A29. I have a PSA level which is over 3.0ng/ml, but I had a normal prostate biopsy. Why am I not being referred for another biopsy, despite my high PSA level?

PSA levels can be raised for a number of reasons, other than the presence of prostate cancer , and only 1 in 3 men with a raised PSA will be found to have cancer at prostate biopsy . During biopsy 10 samples of prostate tissue are taken and analysed under the microscope. These are taken from all areas of the prostate and it is very unusual for a cancer to be present that has not been picked up on biopsy. Therefore, we will monitor your condition at your next annual visit, and watch for trends in your PSA. ...

A28 I have been told that ten cores will be taken when I undergo my prostate biopsy, and two extra for research purposes. Why are the extra two required?

We would like to take tissue samples to use for research to help us to develop new screening tests for prostate cancer .
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