Wednesday, May 18, 2022

Does A Prostate Biopsy Damage The Prostate

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One of the main issues with prostate cancer screening tests is that they can lead to misdiagnosis and as a result, overtreatment.

Even if you take many samples, a biopsy can still sometimes miss cancer. This occurs if none of the biopsy needles pass through the rights areas. Thus, the biopsy will have a false-negative result.

Prostate Biopsy In Clinical Practice

The decision to proceed with biopsy is complex, evolving, and should be made on an individualized basis. Traditionally, biopsy is performed for three general indications: abnormal digital rectal exam , increased prostatic-specific antigen , and clinical suspicion of prostate cancer.

Prior to the advent of PSA screening, prostate biopsy was performed solely for lesions palpable on DRE. Concerning findings on DRE include nodularity, asymmetry, or diffuse firmness. DRE has a poor positive predictive value for detecting cancer and is not recommended as a sole screening tool. However, detection of suspicious gross abnormality on DRE may be an indication for biopsy regardless of PSA depending on contextual patient factors.

PSA is an important biomarker that correlates with the risk of prostate cancer. Screening for prostate cancer using PSA has been shown to reduce prostate cancer mortality, but its utility is highly age dependent. The American Urological Association provides guidance on who should be screened using PSA. Their recommendations include avoiding screening altogether in men under the age of 40, average risk men age 4054, men age 70 or older and men with a life expectancy less than 1015years. They recommend that for men aged 5569, the decision to screen using PSA should be shared amongst the physician and patient and that a biennial interval may preserve the benefits of annual screening while reducing overdiagnosis.

Prostate Biopsy At A Glance

  • A prostate biopsy is the removal of tissue samples from the male prostate gland so a laboratory can examine the tissue for the presence of prostate cancer.
  • A biopsy is generally recommended when a prostate-specific antigen screening, a digital rectal exam or an imaging test indicate a suspicious area that requires further examination.
  • We will discuss our findings with the patient and the prospect of conducting a prostate biopsy to learn more.
  • Urologists perform the removal of the tissue in our offices using transrectal ultrasound and a small needle to obtain cell samples from the prostate for a biopsy.
  • The biopsies are sent to the pathology lab where they are stained and reviewed by a pathologist, with results typically available within one week of the biopsy.
  • Prostate biopsy is the only method of definitively diagnosing prostate cancer.

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A Traditional Prostate Biopsy Which Is A Random Sampling Of The Prostate Can Miss Prostate Cancers Says Michael Herman Md Director Of Urologic Oncology At South Nassau Communities Hospital In Oceanside Ny

The miss rate, continues Dr. Herman, is up to 25 percent of the time. That is not reassuring.

Dr. Herman continues, This often led to patients requiring repeat biopsies because of a persistently elevated PSA.

Solution to Biopsies Missing Prostate Cancer

However, over the last few years, we have developed the use of MRI before biopsy to more accurately target areas in the prostate that are concerning, explains Dr. Herman.

These MRI-targeted biopsies are up to 30 percent more accurate than traditional biopsies.

How We Approach Prostate Biopsies And Prostate Cancer Diagnosis At Ctca

Injection of 99m Tc

When you come to CTCA for a prostate biopsy or a second opinion, youll have access to tests that may help increase the accuracy of each biopsy. Our team has expertise with these tests and procedures, allowing us to work quickly and efficiently.

If youre diagnosed with prostate cancer, a multidisciplinary team of genitourinary experts, which may include a urologist, a urologic oncologist, a radiation oncologist and a medical oncologist, will review your case and develop a personalized plan based on your specific circumstances and needs.

We only treat cancer at CTCA, which means our cancer experts are skilled at assessing risk associated with each persons circumstances. We give you the pros and cons of the treatment options available to you, allowing you time to talk with your team of doctors and other experts about those options.

Our cancer experts are also vigilant about what patients need and when they need it. We know that when men are told they have slow-growing prostate cancer, some of them wont keep up with the necessary follow-ups, so we help keep them on track.

If you choose to receive treatment with us, you may benefit from our integrative approach to cancer treatment. Our multidisciplinary team works together to help prevent and manage the side effects of cancer and its treatment, providing supportive care services, such as:

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What Is A Prostate Biopsy

A prostate biopsy is a procedure to detect prostate cancer. They remove small samples of the prostate and then observed them under the microscope.

Doctors usually recommend a biopsy of your prostate gland based on certain findings. One is if your prostate-specific antigen blood test results are higher than average for your age.

Another is if your doctor detects signs of a prostate problem during your digital rectal exam . Although the PSA and DRE or show a possible problem with your prostate, it requires a biopsy to confirm if its cancer.

A prostate biopsy involves:

  • Collecting minute samples of the prostate gland. The doctor passes a needle through the rectal wall or makes a small cut in the area between the anus and rectum to obtain the samples. A CT or MRI scan is also used to guide them through the procedure.
  • A prostate biopsy takes about 10 minutes and is usually done in the doctors office. The samples will be sent to a lab and will be looked at under a microscope to see if they contain cancer cells.
  • If cancer is detected in the patient, it will also be assigned a grade. The results are available after 1 to 3 days, but it can sometimes take longer.

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What Does My Prostate Do

The prostate is beneath the bladder and in front of the rectum. Itâs a walnut-shaped gland that surrounds part of the urethra. . Hereâs what it does:

  • It produces fluid for semen, which includes sperm produced in the testicles.
  • It prevents urine from being included during ejaculation.

If it gets too big, your prostate can block pee from passing through the urethra and out the penis.

What Will I Experience During And After The Biopsy

Biopsy of the Prostate

If you receive IV contrast for the MRI-guided procedure, you may feel coolness and a flushing sensation for a minute or two when the contrast material is injected. The intravenous needle may cause you some discomfort when it is inserted and you may experience some bruising once it is removed.

Rarely, patients may experience side effects from the MR contrast material, including nausea and local pain, hives, itchy eyes or other reactions. If you experience allergic symptoms, a radiologist or other physician will be available for immediate assistance.

When the ultrasound probe or endorectal coil is inserted into the rectum, you will feel pressure and may have some temporary discomfort.

You will hear a clicking noise when the biopsy needle samples the prostate, and you may feel a stinging or burning sensation in the area.

Some patients find it uncomfortable to remain still during MR imaging. Others experience a sense of being closed-in . Therefore, sedation can be arranged for those patients who anticipate anxiety.

If you feel heating on your skin at any time during MR imaging, the MR technician should be notified so that they can perform a closer examination of the area.

Some patients experience a small amount of bleeding from the rectum or perineum immediately after the biopsy procedure. If this occurs, it will cease with gentle pressure.

You may feel pain and discomfort in the area of the prostate for a day or two after the biopsy, particularly when you are seated.

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Will A Prostate Biopsy Spread Your Cancer

J. Stephen Jones, MD

J. Stephen Jones, MD, is chairman of the department of regional urology at the Cleveland Clinic Glickman Urological and Kidney Institute, and is professor of surgery at Cleveland Clinic Lerner College of Medicine at Case Western Reserve University. He is author of The Complete Prostate Book and Overcoming Impotence.

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Prostate Biopsy Can Cause Urinary Erectile Problems

By Amy Norton, Reuters Health

6 Min Read

NEW YORK – Biopsies taken to diagnose prostate cancer commonly cause temporary erectile dysfunction and, in some cases, lingering urinary problems, according to a new study.

The findings, reported in the Journal of Urology, highlight the fact that even the tests for diagnosing prostate cancer can have side effects.

And men who are undergoing prostate biopsies — as well as those considering prostate cancer screening — should be aware of those risks, experts say.

This is especially important for men facing the prospect of multiple biopsies, since the risk of side effects appears to be related to the number of needle sticks used.

For the study, German researchers followed 198 men who had been randomly assigned to undergo one of three forms of biopsy to check for suspected prostate cancer: a standard biopsy, where a needle was used to take no more than 10 tissue samples a 10-sample biopsy along with the use of a periprostatic nerve block to lessen any pain from the procedure or a saturation biopsy, where 20 tissue samples were taken.

Saturation biopsies may be done in some cases where the doctor suspects a man has a particularly elevated risk of having cancer — such as a man who has had a negative biopsy in the past yet has persistently suspicious findings on PSA screening tests. Taking more tissue samples during the biopsy should increase the chances of finding any tumor.

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There Are Risks To Getting Prostate Cancer Tests And Treatments

If your PSA is not normal, you will probably have a biopsy. The doctor puts a needle through the wall of the rectum and into the prostate to take a few samples. Biopsies can be painful and cause bleeding. Men can get serious infections from biopsies, and they may need hospital care.

Surgery or radiation are the usual treatments for prostate cancer. They can do more harm than good. Treatment can cause serious complications, such as heart attacks, blood clots in the legs or lungs, or even death. In addition, 40 men out of 1,000 will become impotent or incontinent from treatment.

Types Of Prostate Biopsy Method

Prostate biopsy tests can be gathered in various ways. Your prostate biopsy may include:

  • The needle going through the mass of the rectum . This is the most widely recognized method for performing a prostate biopsy.
  • Inserting the needle through the area of skin between the butt and scrotum . A little cut is made in the skin area between the butt and the scrotum. The biopsy needle is embedded through the cut and into the prostate to draw out a specimen of tissue. An MRI or CT output is for the most part used to guide this technique.

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Dr. Peter Ruff – Prostate Biopsy With Elevated PSA

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