Q: How Was My Gleason Score Determined
A: Your 12-needle biopsy, which is the standard procedure for prostate biopsy, was sent to a pathology doctor who looked at your biopsy specimens under the microscope. Then, based upon his experience, he determined your Gleason score, wrote your biopsy report and sent it to your urologist.
Figure 2. The 12 needle cores taken during prostate biopsy of Bill Smith.
How Long After Prostate Biopsy Is There Blood In Semen
Blood In Semen. Image courtesy of dream designs at FreeDigitalPhotos.net
QUESTION: I want to know how long after prostate biopsy is there blood in semen?
ANSWERprostate biopsy
Q: Am I Guaranteed To Have Gleason Score 4+3 If That Is What My Results Showed
A: No and there are two reasons. First, when a 12-needle biopsy is performed, only a tiny amount of prostate tissue is removed. Thus, a needle could hit a large area of tumor and show that you have a Gleason score of 4+3. However, it is possible that you could have a small area of Gleason 4+4=8 or more that was missed. We learned this from comparing biopsy Gleason scores to men who later had a Radical Prostatectomy in which the entire prostate is studied. Fortunately, this is uncommon with the 12-needle biopsy. As for the second reason, the Gleason score determination is made by the pathologist who looked at your biopsy material. The accuracy depends on his skill and experience. Thus, pathologists can sometimes make a mistake in the Gleason score. Because of this, we always have a mans biopsy material double checked by expert pathologists before we treat someone.
How Should You Prepare For A Prostate Ultrasound And Biopsy
Preparation for a prostate ultrasound and biopsy is simple. You shouldnt take any blood-thinning medications such as warfarin , clopidogrel , aspirin or ibuprofen before a prostate biopsy because blood thinner increase the risk of bleeding. If you are already taking blood thinners, your doctor will discuss with you how many days prior to the biopsy they should be held.
Most healthcare providers dont ask you to follow any type of special diet before a biopsy. However, they suggest eating lightly before the procedure and drinking only clear liquids. Check with your providers office to see if you need to do anything additional to prepare for the test.
What Are The Side Effects Of A Biopsy
Having a biopsy can cause side effects. These will affect each man differently, and you may not get all of the possible side effects.
Pain or discomfort
Some men feel pain or discomfort in their back passage for a few days after a TRUS biopsy. Others feel a dull ache along the underside of their penis or lower abdomen . If you have a transperineal biopsy, you may get some bruising and discomfort in the area where the needle went in for a few days afterwards.
If you receive anal sex, wait about two weeks, or until any pain or discomfort from your biopsy has settled, before having sex again. Ask your doctor or nurse at the hospital for further advice.
Some men find the biopsy painful, but others have only slight discomfort. Your nurse or doctor may suggest taking mild pain-relieving drugs, such as paracetamol, to help with any pain.
If you have any pain or discomfort that doesnt go away, talk to your nurse or doctor.
Short-term bleeding
A small number of men who have a TRUS biopsy may have more serious bleeding in their urine or from their back passage . This can also happen if you have a transperineal biopsy but it isn’t very common. If you have severe bleeding or are passing lots of blood clots, this is not normal. Contact your doctor or nurse at the hospital straight away, or go to the accident and emergency department at the hospital.
Infection
Symptoms of a urine infection may include:
- a high temperature
How Long Do Prostate Cancer Biopsy Results Take
- Post author
- June 25, 2018
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Biopsy: Things You Need To Know
The first thing you should know is that theres still plenty of room for confusion after a . The prostate in a young man is about the size of a walnut; with age and it can get bigger think of a lime, or a lemon, or even an orange. Now, imagine that you have about 14 tiny needles; each needle has a hollow center, and when it is stuck into the prostate, it takes out a very small core of tissue. Theres a lot of potential to miss any cancer that might be hiding in there.
This is why many men end up getting multiple repeat biopsies, says NYU Stacy Loeb, M.D. This means that you might have a that is elevated. Your doctor orders a , and no cancer is found. But the PSA keeps on creeping up, so your doctor recommends another biopsy, and maybe even another. About a third of men in one study got another biopsy within five years of a negative biopsy, says Loeb. If the PSA is elevated, do we do another biopsy, or what do we do? This is where some of the second-line PSA tests, like the Prostate Health Index or 4K Score, can be helpful.
A urine test, called the PCA3 test, may also be helpful. Unlike the PSA test, which is prostate-specific but not cancer-specific , the PCA3 test targets genes produced by prostate cancer cells.
First, it can hurt. To get to the prostate, the doctor goes through your rectum. With needles. To minimize pain, your urologist may use conscious sedation or an anesthetic called a prostatic block .
What Abnormal Results Mean
A positive biopsy result means that cancer cells have been found. The lab will give the cells a grade called a Gleason score. This helps predict how fast the cancer will grow. Your doctor will talk to you about your treatment options.
The biopsy may also show cells that look abnormal, but may or may not be cancer. Your provider will talk with you about what steps to take. You may need another biopsy.
The Test Is Often Not Needed
Most men with high PSAs dont have prostate cancer. Their high PSAs might be due to:
- An enlarged prostate gland.
- Recent sexual activity.
- A recent, long bike ride.
Up to 25% of men with high PSAs may have prostate cancer, depending on age and PSA level. But most of these cancers do not cause problems. It is common for older men to have some cancer cells in their prostate glands. These cancers are usually slow to grow. They are not likely to spread beyond the prostate. They usually dont cause symptoms, or death.
Studies show that routine PSA tests of 1,000 men ages 55 to 69 prevent one prostate cancer death. But the PSA also has risks.
Precancerous Cells And Pin
Sometimes, the results will show that precancerous cells, or prostatic intraepithelial neoplasia , are present.
If these PIN are low grade, the doctor will not consider this a matter of concern. Many men have low grade PIN.
However, if the PIN are high grade, there is a chance that cancer may develop. In these cases, a doctor may suggest further tests.
in situ refers to cells that are not yet cancerous but could become so. They can occur almost anywhere in the body.
The outlook depends on the results of the biopsy and other tests.
If results show that cancer is present in or around the prostate gland only, there is an almost 100% chance of surviving at least another 5 years. This is because effective treatment is available, and because many types of prostate cancer are slow growing.
However, if cancer has spread to other organs, such as the liver or lungs, the chance of someone surviving another 5 years or more falls to 30%.
Factors that affect the outlook for a person with prostate cancer include:
- their age and overall health
- the type of cancer present
- how far cancer has spread
What Can You Expect During A Prostate Ultrasound And Biopsy
The procedure is short and generally only takes about 10 minutes. Your urologist, a doctor specializing in mens genital and urinary problems, will perform the procedure.
- Upon arrival in the examination room, you will be given antibiotics to prevent infection.
- You will be asked to lie on your side and bring your knees to your chest.
- The area being tested may be numbed to help reduce any discomfort.
- A lubricated probe is inserted into the rectum to generate the ultrasound.
- A small needle is inserted through the probe to take several tiny tissue samples from the prostate. Some men may feel mild pressure or discomfort during the procedure.
- After tissue samples are taken, they are sent to a lab for an analysis.
Does The Prostate Swell After A Biopsy
This happens because the biopsy can cause the prostate to swell, making it difficult to urinate. Acute urine retention may be more likely if you have a template biopsy. This is because more samples are taken, so there may be more swelling. Your doctor will make sure you can urinate before you go home after your biopsy.
Biopsy And Gleason Score
A pathologist looks for cell abnormalities and “grades” the tissue sample from 1 to 5. The sum of two Gleason grades is the Gleason score. These scores help determine the chances of the cancer spreading. Gleason grades of 1 and 2 are not usually given in biopsies, so 6 is typically the lowest score for a prostate cancer. Cancer with Gleason scores of 8 to 10 is called high-grade, and can grow and spread more quickly. Gleason scores help guide the type of treatment your doctor will recommend.
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Preparing For Your Biopsy
You have the biopsy under local or general anaesthetic.
Having the biopsy under local anaesthetic means you should be able to eat and drink normally before the test.
Having the biopsy under general anaesthetic means that you wont be able to eat or drink for a number of hours beforehand. You usually stop eating at least 6 hours before the biopsy and stop drinking at least 4 hours beforehand. Your team will give you instructions.
Take your usual medicines as normal, unless you have been told otherwise. If you take warfarin to thin your blood, you should stop this before your biopsy. Your doctor will tell you when to stop taking it.
You have antibiotics to stop infection developing after the biopsy. You have them before the biopsy and for a few days afterwards.
You might have a tube into your bladder to drain urine.
Your doctor will ask you to sign a consent form once you have all the information about the procedure.
What Are The Limitations Of Ultrasound
A biopsy can only show if there is cancer in the samples taken, so it is possible that cancer in unsampled areas of the prostate might be missed.
For MRI-guided biopsies, high-quality images are assured only if you are able to remain perfectly still while the images are being recorded. If you are anxious, confused or in severe pain, you may find it difficult to lie still during imaging, and the resulting images may not be of sufficient quality to be useful as a diagnostic tool.
Likewise, the presence of an implant or other metallic object sometimes makes it difficult to obtain clear MR images. A person who is very large may not fit into the opening of certain types of MRI machines.
MR imaging cannot always distinguish between cancer tissue and inflammation or the presence of blood products within the prostate, which sometimes occurs related to a prostate biopsy. To avoid confusing the two on imaging, prostate MR imaging may be performed six to eight weeks after prostate biopsy, if possible, to allow any residual bleeding to resolve itself.
MRI typically costs more and may take more time to perform than other imaging methods. Talk to your insurance provider if you have concerns about the cost of MRI.
Getting The Results Of The Biopsy
Your biopsy samples will be sent to a lab, where they will be looked at with a microscope to see if they contain cancer cells. Getting the results usually takes at least 1 to 3 days, but it can sometimes take longer. The results might be reported as:
- Positive for cancer: Cancer cells were seen in the biopsy samples.
- Negative for cancer: No cancer cells were seen in the biopsy samples.
- Suspicious: Something abnormal was seen, but it might not be cancer.
If the biopsy is negative
If the prostate biopsy results are negative , and the chance that you have prostate cancer isnt very high based on your PSA level and other tests, you might not need any more tests, other than repeat PSA tests sometime later.
But even if many samples are taken, biopsies can still sometimes miss a cancer if none of the biopsy needles pass through it. This is known as a false-negative result. If your doctor still strongly suspects you have prostate cancer , your doctor might suggest:
- Getting other lab tests to help get a better idea of whether or not you might have prostate cancer. Examples of such tests include the Prostate Health Index , 4Kscore test, PCA3 tests , and ConfirmMDx. These tests are discussed in Whats New in Prostate Cancer Research?
- Getting a repeat prostate biopsy. This might include getting additional samples of parts of the prostate not biopsied the first time, or using imaging tests such as MRI to look more closely for abnormal areas to target.
Prostate cancer grade
Gleason score
How Does The Procedure Work
Ultrasound procedure:
Ultrasound imaging is based on the same principles involved in the sonar used by bats, ships and fishermen. When a sound wave strikes an object, it bounces back, or echoes. By measuring these echo waves, it is possible to determine how far away the object is as well as the object’s size, shape and consistency. This includes whether the object is solid or filled with fluid.
In medicine, ultrasound is used to detect changes in the appearance of organs, tissues, and vessels and to detect abnormal masses, such as tumors.
In an ultrasound exam, a both sends the sound waves and records the echoing waves. When the transducer is pressed against the skin, it sends small pulses of inaudible, high-frequency sound waves into the body. As the sound waves bounce off internal organs, fluids and tissues, the sensitive receiver in the transducer records tiny changes in the sound’s pitch and direction. These signature waves are instantly measured and displayed by a computer, which in turn creates a real-time picture on the monitor. One or more frames of the moving pictures are typically captured as still images. Short video loops of the images may also be saved.
MRI procedure:
A computer processes the signals and creates a series of images, each of which shows a thin slice of the body. These images can be studied from different angles by the radiologist.
MRI is able to tell the difference between diseased tissue and normal tissue better than x-ray, CT and ultrasound.
Biopsy During Surgery To Treat Prostate Cancer
If there is more than a very small chance that the cancer might have spread , the surgeon may remove lymph nodes in the pelvis during the same operation as the removal of the prostate, which is known as a radical prostatectomy .
The lymph nodes and the prostate are then sent to the lab to be looked at. The lab results are usually available several days after surgery.
Painful Prostate Biopsy Heres What You Need To Know
A standout amongst the most famous symptomatic tests performed to recognize Prostate Cancer is Biopsy. If you are experiencing pee issues, erectile brokenness, or any prostate-related indications and would look for medical counsel from a medical expert, the standard suggestion would either be for you to experience the PSA test first then Prostate Biopsy or the last quickly.
How The Test Will Feel
During the procedure you may feel:
- Mild discomfort while the probe is inserted
- A brief sting when a sample is taken with the biopsy needle
After the procedure, you may have:
- Soreness in your rectum
- Small amounts of blood in your stools, urine, or semen, which may last for days to weeks
- Light bleeding from your rectum
To prevent infection after the biopsy, your provider may prescribe antibiotics to take for several days after the procedure. Be sure you take the full dose as directed.
What Is A Trus Biopsy
This is the most common type of biopsy in the UK. The doctor or nurse uses a thin needle to take small samples of tissue from the prostate.
Youll lie on your side on an examination table, with your knees brought up towards your chest. The doctor or nurse will put an ultrasound probe into your back passage , using a gel to make it more comfortable. The ultrasound probe scans the prostate and an image appears on a screen. The doctor or nurse uses this image to guide where they take the cells from. If youve had an MRI scan, the doctor or nurse may use the images to decide which areas of the prostate to take biopsy samples from.
You will have an injection of local anaesthetic to numb the area around your prostate and reduce any discomfort. The doctor or nurse then puts a needle next to the probe in your back passage and inserts it through the wall of the back passage into the prostate. They usually take 10 to 12 small pieces of tissue from different areas of the prostate. But, if the doctor is using the images from your MRI scan to guide the needle, they may take fewer samples.
The biopsy takes 5 to 10 minutes. After your biopsy, your doctor may ask you to wait until you’ve urinated before you go home. This is because the biopsy can cause the prostate to swell, so they’ll want to make sure you can urinate properly before you leave.
Scared Stiff Of Having A Prostate Biopsy
Although the and tests are useful, they are not enough to make a clear diagnosis of prostate cancer. When results are abnormal or questionable, the doctor may prescribe a transrectal ultrasound and a biopsy. These examinations usually provide enough information for a precise diagnosis.
Having to undergo prostate biopsies can be scary: fear of the intervention, the pain it can cause, the unknown … or knowing you have prostate cancer. But remember, if you have cancer, the sooner it is diagnosed, the greater your chances of a complete cure with treatment!
Why a biopsy
Abnormalities detected during a digital rectal exam and a high PSA level often lead to a prostate biopsy. This procedure consists of taking small tissue samples of your prostate in order for the pathologist to examine them under a microscope to determine if they are cancerous or not.
That prostate biopsies are indicated does not mean that you necessarily have prostate cancer. Indeed, the analysis of microscopic specimens makes it possible to differentiate a benign hypertrophy from a cancer of the prostate.
To this day, the actual diagnosis of prostate cancer can only be made with a prostate biopsy.
How
Coping With Erectile Dysfunction
Erectile dysfunction is a common side effect of prostate cancer treatments. Generally, erectile function improves within two years after surgery. Improvement may be better for younger men than for those over age 70. You also may benefit from ED medications. Other treatments, such as injection therapy and vacuum devices, may help.
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Why Is A Prostate Biopsy Done
A prostate biopsy is done to screen for prostate cancers. This is to confirm whether is present, or if a prostate cancer diagnosis is aggressive. In a prostate biopsy, small samples of the prostate are removed and then observed under the microscope. Doctors usually recommend a biopsy of the prostate gland based on certain findings.
- If prostate-specific antigen blood test results are higher than the average age
- If the doctor detects signs of a prostate problem during a digital rectal exam
- If a biopsy is the only method to confirm the
A prostate biopsy involves:
- Collecting minute samples of the prostate gland. A computed tomography or magnetic resonance imaging 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 cells.
- If cancer is detected in the patient, it will also be assigned a grade. The results are available after one to three days, but it can sometimes take longer.
A prostate biopsy may be done in several different ways which may include:
How Is The Biopsy Procedure Performed
Ultrasound-guided biopsy procedure:
The ultrasound-guided prostate biopsy is carried out by a radiologist or urologist, assisted by a sonographer and often a nurse who helps look after the patient.
You may have a small enema inserted into your rectum half an hour or so before the procedure to clean out your bowels and clear the rectum of feces so that the prostate may be seen more clearly with the ultrasound and to lower the risk of infection.
The procedure is often carried out after you have been given a light general anesthetic, which means you will be asleep or sedated during the procedure. If the procedure is carried out using an anesthetic, an anesthesiologist will be present.
During the procedure, you will be asked to lie on your left side with your legs bent.
The physician will first carry out a DRE with a gloved finger.
An ultrasound probe will then be inserted into your rectum. The probe is sterilized, covered with condoms to ensure protection from any infection or contamination, and lubricated to help it glide easily into your rectum.
After examination of your prostate with the ultrasound, the physician will perform the biopsy. Pictures or images the physician can see on the ultrasound screen are used to guide a very fine needle, through the wall of your rectum into the prostate and take a sample of tissue. With continuous ultrasound imaging, the physician is able to view the biopsy needle as it advances to the prostate in real time.
MRI-guided biopsy procedure: