Imaging Tests For Prostate Cancer
Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. One or more imaging tests might be used:
- To look for cancer in the prostate
- To help the doctor see the prostate during certain procedures
- To look for spread of prostate cancer to other parts of the body
Which tests you might need will depend on the situation. For example, a prostate biopsy is typically done with transrectal ultrasound and/or MRI to help guide the biopsy. If you are found to have prostate cancer, you might need imaging tests of other parts of your body to look for possible cancer spread.
The imaging tests used most often to look for prostate cancer spread include:
What Happens After A Prostate Biopsy
Your recovery process will vary depending on the type of anesthesia that isused. If you were given general anesthesia, you will be taken to a recoveryroom for observation. Once your blood pressure, pulse, and breathing arestable and you are alert, you will be taken to your hospital room ordischarged to your home.
If local anesthetic was used, you may go back to your normal activities anddiet unless otherwise instructed. You may feel the urge to urinate or havea bowel movement after the biopsy. This feeling should pass after a fewhours.
There may be blood in your urine or stool for a few days after the biopsy.This is common. Blood, either red or reddish brown, may also be in yourejaculate for a few weeks after the biopsy. This, too, is normal.
The biopsy site may be tender or sore for several days after the biopsy.Take a pain reliever for soreness as recommended by your healthcareprovider. Aspirin or certain other pain medicines may increase the chanceof bleeding, so be sure to take only recommended medicines.
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Increase in the amount of blood in your urine or stool
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Belly or pelvic pain
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Trouble urinating
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Changes in the way your urine looks or smells or burning with urination
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Fever and/or chills
Your healthcare provider may give you other instruction, depending on yoursituation.
Day After The Prostate Biopsy
After your biopsy, you will have to drink many fluids so that you may provide us with two separate urine samples from two separate voids. The most common complication is blood in the urine after the biopsy. We would like to make sure that your urine is in the process of clearing before we send you home for the day. It is normal to see blood in the urine and bowel movements for 1-2 weeks after the procedure. It should progressively diminish over that time-period. If you find that, you cannot urinate or if you are passing a large number of blood clots, then report to the office or nearest emergency room for evaluation. A physician may have to insert a catheter into the bladder for a few days to allow you urine to be drained. You should continue to drink more than your usual intake of fluids to keep your urine diluted and to prevent formation of blood clots within the bladder.
You may also experience a dull ache in the perineum for many days after the biopsy. It is recommended that you halt sexual intercourse for 3-5 days after the biopsy to allow some initial healing. Do not be surprised if you see blood in your semen after ejaculation. This is normal and does not cause an infectious concern for your sexual partner. This may take months to resolve. In addition, you cannot pass along cancer to your partner via your semen either.
If you have fever or chills, please take your temperature with an oral thermometer and call your physician if it reads above 100.8 F.
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What Is Prostate Cancer Screening
The diagnosis of prostate cancer usually follows a biopsy prompted by a significantly elevated initial PSA level, an increase in PSA levels over time, or an abnormal digital rectal examination. According to JAMA, patients with a prostate cancer history benefit from extended PSA monitoring. Elevated PSA levels may help determine when to go in for a prostate MRI and hopefully avoid unnecessary or repeat prostate biopsies.
The American Journal of Mens Health reports that prostate cancer diagnosis occurs most often in men older than 50. Other factors influencing the rate of prostate cancer are ethnicity and family history. Screening is vital because localized prostate cancer sometimes causes no symptoms or warning signs.
What Does The Equipment Look Like
Ultrasound equipment:
Ultrasound scanners consist of an electronic console containing a computer, video monitor, and a handheld transducer . The transducer sends out inaudible high frequency sound waves into the body and listens for the returning echoes. The principle is similar to the sonar used by boats and submarines.
The computer displays the ultrasound image on a video monitor. This image is based on the amplitude and frequency of the signal. It is also based on signal travel time, tissue composition, and the type of body structure through which the sound travels.
The ultrasound probe for a prostate biopsy is about the size of a finger. Once the doctor inserts the probe into the rectum, they take tissue samples using a spring-driven needle core biopsy device . The handheld device includes a long but very thin needle. The needle opens inside the prostate, takes the sample, and then closes.
MRI equipment:
The traditional MRI unit is a large cylinder-shaped tube surrounded by a circular magnet. You will lie on a table that slides into a tunnel towards the center of the magnet.
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What Should I Expect During My Prostate Biopsy
before and after the prostate biopsy?
preparing for the day
The choice to undergo a biopsy of the prostate is an important decision. After a PSA blood test and likely an MRI of the prostate gland as well, you and your doctor have come to the decision that a biopsy of the prostate gland is best for you. With biopsy, several small samples of tissues are taken for the prostate gland. In way, the doctor will get better idea of the presence or aggressiveness of prostate cancer. Let find out more about you can expect before and after your prostate biopsy.
During your procedure, there are several steps you should expect. After changing into a hospital gown, you may be asked to lay on your side of back with your knees bent. Especially if your biopsy is being obtain by a different approach other than the transrectal method, you may receive some medication to calm you for the moment, therefore it is important to have someone with to take you home. Your rectal area will be further cleaned and prepared for biopsy. Local numbing medication is injection at the site of the biopsy. You may feel some discomfort initially as this medical is applied. Otherwise, you may feel about 12 pinches to the rectal area as the biopsies from different parts of the prostate are taken. Afterwards the area is clean and you will have a recovery period to ensure you are safe to return home.
Genetic Testing For Some Men With Prostate Cancer
Some doctors now recommend that some men with prostate cancer be tested to look for certain inherited gene changes. This includes men in whom a family cancer syndrome is suspected, as well as men with prostate cancer that has certain high-risk features or that has spread to other parts of the body. Talk to your doctor about the possible pros, cons, and limitations of such testing.
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How Is Blood In Semen Diagnosed
Initial evaluation
Your healthcare provider will:
- Take a full medical history, including asking questions about your current symptoms, when you first noticed the blood, how often youve seen blood in your semen, and your sexual activities/practices. You will also be asked about medications you take, if youve had any recent medical procedures, have any bleeding disorders, or have any symptoms of a urinary tract infection.
- Conduct a physical exam to check for lumps, swelling, redness or discharge from your genitals.
- Perform a rectal exam to check the prostate for swelling, tenderness or a lump.
- Check your blood pressure.
Your healthcare provider may order one or more of these tests:
- Urine culture to check for infections or abnormalities.
- STD test to detect any sexually-transmitted disease.
- Prostate Specific Antigen test to check for prostate cancer.
Specialized tests
The results of your exam and tests may not show the cause of blood in your semen. Your provider may refer you to a urologist if your initial evaluation and urinalysis are not normal or if blood in your semen in present for longer than a month. Your urologist may order some or all of the following tests:
- Transrectal ultrasound to diagnosis prostate problems including cysts, calculi, varices, inflammatory changes.
- Computed tomography or magnetic resonance imaging .
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What Is A Prostate Ultrasound And Biopsy And Why Would You Need One
The prostate is the part of your body that makes fluid for semen, which is the fluid that carries sperm. The gland surrounds part of your urethra, which is the tube that carries urine and sperm outside of the body. The prostate has muscles that move the sperm out of the body.
If you are having problems with your prostate, you might be having difficulties related to pushing urine or sperm out of your urethra and penis. Your healthcare provider may ask you to have a prostate ultrasound and biopsy to check for prostate cancer.
A prostate ultrasound probe is inserted into the rectum and uses sound waves to produce images inside the rectum to help image the prostate and guide the doctor in taking a biopsy of the prostate gland. Prostate ultrasound and biopsy are used to diagnose prostate cancer or to find the reason for other problems. A doctor may require this test if a patient has high levels of prostate-specific antigen found in a blood test, or has an abnormal prostate exam both suggesting that the patient may have a high risk for prostate cancer.
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Use In Men Already Diagnosed With Prostate Cancer
The PSA test can also be useful if you have already been diagnosed with prostate cancer.
- In men just diagnosed with prostate cancer, the PSA level can be used together with physical exam results and tumor grade to help decide if other tests are needed.
- The PSA level is used to help determine the stage of your cancer. This can affect your treatment options, since some treatments are not likely to be helpful if the cancer has spread to other parts of the body.
- PSA tests are often an important part of determining how well treatment is working, as well as in watching for a possible recurrence of the cancer after treatment .
Day Before Prostate Biopsy
You will be given a prescription for an antibiotic that should be the day before and the morning of your biopsy. Enough antibiotics have been given for you to continue taking them for two more days after the biopsy. You will also have to purchase two fleets enemas at your local pharmacy. Follow the instructions in the box and take one the evening before and one two hours before your biopsy. You should also not eat any solid foods after dinner the night before your biopsy. You may drink any type of liquid that you choose right up to the point of your biopsy. It helps to have some fluid in the bladder during the biopsy.
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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 To Prepare For The Test
Your provider will inform you about the risks and benefits of the biopsy. You may have to sign a consent form.
Several days before the biopsy, your provider may tell you to stop taking any:
- Anticoagulants such as warfarin, , clopidogrel , apixaban , dabigatran , edoxaban , rivaroxaban , or aspirin
- NSAIDs, such as aspirin and ibuprofen
- Herbal supplements
Continue to take any prescription medicines unless your provider tells you not to take them.
Your provider may ask you to:
- Eat only light meals the day before the biopsy.
- Do an enema at home before the procedure to cleanse your rectum.
- Take antibiotics the day before or on the day of your biopsy.
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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.
How Doctors Determine Whether To Recommend A Prostate Biopsy
No two patients are alike, and a urologist needs to take many variables into account before recommending a prostate biopsy, including a patients:
- Age and life expectancy
- Comorbidities
- Change in PSA values across time.
The decision of whether to undergo a prostate biopsy should be determined after an individual conversation with your doctor during which he or she presents you with the big picture of your situation.
Compare, for example, the case of two 50-year-old men: One of them has been diagnosed with heart failure and is in poor overall health. The other has no pre-existing health conditions. I probably wouldnt advise a prostate biopsy for the 50-year-old with heart failure because prostate cancer is unlikely to cause his death within the next five years.
But I would recommend that the healthy 50-year-old get a prostate biopsy, because even if his cancer isnt aggressive right now, missing a prostate cancer diagnosis may result in his death from the disease in 15 years. In his case, it would be better to risk the prostate biopsy to catch the cancer early and improve his chances of long-term survival.
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What Happens After A Prostate Ultrasound And Biopsy
When the procedure is finished, you may resume your normal meals and daily activities, unless otherwise instructed. Some urologists may prescribe an antibiotic after the biopsy to prevent any infections, but given antibiotics only prior to the biopsy. Some men may have soreness for a few days after the procedure, which is normal. Your provider will contact you when your results are available
The Prostate Biopsy Procedure
A urologist safely performs prostate biopsies in the Urology Associates office using local anesthesia. We use a special needle in a prostate needle biopsy , approaching the prostate through the rectum wall. The urologist employs ultrasound imaging to inspect the prostate and to precisely guide the needle that takes the biopsy sample. This is known as transrectal ultrasound biopsy.
A tiny bit of the prostate gland is withdrawn through the needle. We will typically withdraw about 12 core samples from different parts of the prostate in order to map multiple areas. This gives us a more complete picture of the gland and possible issues.
We then send these biopsy samples to a pathology lab. We will get the results back in about one week after the biopsy. The urologist will share this information with the patient, including a clear explanation of the pathology report. These results will help us determine with the patient the proper course of action.
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How We Approach Prostate Biopsies And Prostate Cancer Diagnosis At Ctca
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: