When Should You Have A Prostate Biopsy

What Is A Mi

The MiPS score helps to evaluate your risk of prostate cancer and aggressive prostate cancer. Its usually performed after you have abnormal results from a PSA test and DRE.

This test involves a DRE, after which youll provide a urine sample. The Mi-prostate score combines three markers:

• serum PSA
• PCA3
• TMPRSS2:ERG

PCA3 and T2:ERG are genes found in the urine. Its rare for men without prostate cancer to have high amounts of these markers in their urine. The higher your levels, the more likely it is that you have prostate cancer.

A MiPS provides more information than a PSA test alone. Its a valuable risk assessment tool and may be helpful in deciding whether or not to go ahead with a biopsy. Like other tests, a MiPS test alone cannot confirm prostate cancer.

Tests To Diagnose And Stage Prostate Cancer

Most prostate cancers are first found as a result of screening. Early prostate cancers usually dont cause symptoms, but more advanced cancers are sometimes first found because of symptoms they cause.

If prostate cancer is suspected based on results of screening tests or symptoms, tests will be needed to be sure. If youre seeing your primary care doctor, you might be referred to a urologist, a doctor who treats cancers of the genital and urinary tract, including the prostate.

The actual diagnosis of prostate cancer can only be made with a prostate biopsy .

On this page

• Lymph node biopsy

The Prostate Gland And Its Function

According to urologyhealth.org, the prostate gland belongs to the male reproductive system. Being the size of a walnut, it weighs approximately one ounce. The prostate is found below the bladder and in front of the rectum. You will also find the prostate going completely around the urethra which carries urine from the bladder out through the penis.

The primary function of the prostate is to make fluid for semen. At the time of ejaculation, sperm made in the testicles moves to the urethra. Concurrently, fluid from the prostate and seminal vesicles also moves into the urethra. This semen mixture passes through the urethra and out of the penis at the time of orgasm.

Don’t Miss: What Happens If You Have Prostate Cancer

What Is A Prostate Biopsy And Why Is It Necessary

According to an article from the Mayo Clinic, prostate biopsy tissue samples are usually collected by transrectal or transperineal means.

A transrectal biopsy is the most common way. In this procedure, a needle is passed through the wall of the rectum.

In a transperineal biopsy, a needle is inserted through the skin between the anus and the scrotum. After a small cut is made in the skin area between the anus and scrotum, a biopsy needle is inserted through the cut and into the prostate to get out a sample of tissue. An MRI or CT scan is usually used to guide this procedure.

Urologists generally advise a prostate biopsy when PSA readings over a length of time are high and/or a digital rectal exam and ultrasound indicate abnormalities on the prostate. According to doctors, this is the only definite way to diagnose prostate cancer.

What Is A Prostate Biopsy

There are two main types of prostate biopsies transrectal ultrasound guided biopsies and transperineal biopsies. As the former tends to be more common, well focus on this method.

biopsies use ultrasound guidance with a biopsy tool to snip core samples from the prostate gland. An ultrasound probe and biopsy tool are introduced into the rectum where a biopsy needle penetrates the rectal wall and enters the prostate. The procedure is repeated up to 12 times.

Transrectal prostate biopsies are outpatient or in-office procedures that require only numbing medicine. Passing a needle through the rectum and into the prostate places you at risk of infection. To minimize the risk of infection, urologists commonly prescribe antibiotics beforehand.;

Other complications from prostate biopsies include:

• Blood in urine, semen, and stool
• Pain

Also Check: What Are The Early Signs Of Prostate Cancer

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.

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.

You May Like: How Effective Is Proton Beam Therapy For Prostate Cancer

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.

How Long Does It Take To Recover From A Prostate Biopsy

A patient may take about four to six weeks or even more recover after a prostate biopsy. The recovery process after biopsy usually depends on the patient’s health and age. Doctors may recommend only light activities for 24-48 hours after a prostate biopsy. The doctor prescribes painkillers, vitamins, and antibiotics for a few days to speed up the healing process.

After the biopsy, it is normal to experience the following sensations or symptoms:

• Burning urination: It may start within 24 hours after the biopsy and may continue until three to seven days. This burning sensation is a side effect of the procedure and usually considered normal.;
• Frequent urination: It may gradually improve over the first 24-36 hours.
• Blood in the urine: It is considered normal to have slightly red-tinged urine or urine that resembles the color of a rose or red wine. This may last from 12 hours to 3 weeks after the biopsy.
• Blood in stool: A patient may notice red stains on the toilet tissue or see some bloody streaks in the stool. This may last for up to five days.
• Blood in the semen: This may persist for up to six weeks after the biopsy.
• Tiredness: A patient may feel tired for a month or two. It usually takes 30-45 days to regain full normal strength after the procedure; hence, sufficient rest is usually advised by the doctor.;

Post-biopsy restrictions and instructions:

Read Also: Can Masturbation Cause Prostate Cancer

How Are Researchers Trying To Improve The Psa Test

Scientists are investigating ways to improve the PSA test to give doctors the ability to better distinguish cancerous from benign conditions and slow-growing cancers from fast-growing, potentially lethal cancers. None has been proven to decrease the risk of death from prostate cancer. Some of the methods being studied include:

Further Testing For Advanced Cancer

If there’s a significant chance the cancer has spread from your prostate to other parts of the body, further tests may be recommended.

These include:

• an MRI scan, CT scan or PET scan these scans build a detailed picture of the inside of your body
• an isotope bone scan, which can tell if the cancer has spread to your bones a small amount of radiation dye is injected into the vein and then collects in parts of the bone where there are any abnormalities

Also Check: What Are The Symptoms Of Prostatitis

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.

A History Of Prostate Gland Problems

Since January of 1999, I have been afflicted with prostate gland problems. After a routine blood test ordered by a family doctor indicated an elevated prostate-specific antigen reading, I started seeing urologists in 1999. While under their care, I had a first prostate biopsy performed in Maryland in July of 2000 and a second in Thailand in December of 2003. Following a diagnosis of an enlarged prostate or BPH, I have been advised since the first biopsy to have regular PSA testing and if necessary, additional biopsies.

The prostate-specific antigen is a protein produced by normal as well as malignant cells of the prostate gland. A normal PSA reading is 4.0 or lower. If the reading is above 4, there is an indication that the prostate may have malignant cells.

After the second prostate biopsy, I have had periodic PSA tests through the present. Since 2015, however, my urologist in Thailand has prescribed a drug for me to take to shrink the prostate. Its growth and condition have been monitored through semi-annual ultrasounds and PSA readings.

In this article, after first stating the function of the male prostate gland and describing BPH, I discuss the need for biopsies. Then, based on personal experiences, I relate what to expect after a prostate biopsy.

Read Also: What Age To Get Prostate Checked

What Does A Digital Rectal Exam Do

In a digital rectal exam , the doctor inserts a gloved finger into your rectum to feel for irregularities of the prostate. Its a common part of a mans routine physical examination.

Your doctor might perform a DRE alone or with a PSA test for routine screening. Its a quick and simple test. Although a DRE can signal a problem, such as an enlarged prostate, it cannot determine if its due to prostate cancer.

Prostate cancer is diagnosed 15 to 25 percent of the time when abnormal findings on a DRE lead to biopsy.

What Does A Prostate Biopsy Involve

If you decide to have a biopsy, youll either be given an appointment to come back to the hospital at a later date or offered the biopsy straight away.

Before the biopsy you should tell your doctor or nurse if youre taking any medicines, particularly antibiotics or medicines that thin the blood.

You may be given some antibiotics to take before your biopsy, either as tablets or an injection, to help prevent infection. You might also be given some antibiotic tablets to take at home after your biopsy. Its important to take them all so that they work properly.;

A doctor, nurse or radiologist will do the biopsy. There are two main types of biopsy:

• a trans-rectal ultrasound guided biopsy, where the needle goes through the wall of the back passage
• a transperineal biopsy, where the needle goes through the skin between the testicles and the back passage .

Also Check: Why Does Enlarged Prostate Cause Frequent Urination

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.

• Increase in the amount of blood in your urine or stool

• Belly or pelvic pain

• Trouble urinating

• Changes in the way your urine looks or smells or burning with urination

• Fever and/or chills

Your healthcare provider may give you other instruction, depending on yoursituation.

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.

Recommended Reading: How Accurate Is Mri In Diagnosing Prostate Cancer

Screenings Can Lead To High Costs

The cost for a PSA test is fairly lowabout $40.

If your result is abnormal, the costs start adding up. Your doctor will usually refer you to a urologist for a biopsy. Costs may include:

• A consultation fee .
• An ultrasound fee .
• Additional professional fees .
• Biopsy fees .

If the biopsy causes problems, there are more costs. You might also have hospital costs.

What Are Some Common Uses Of The Procedure

A prostate biopsy is currently the only way to definitively diagnose prostate cancer. It also helps differentiate cancer from benign prostatic hyperplasia;or nodular enlargement of the prostate, a very common condition in middle-aged and older men that requires a different treatment approach than that of cancer.

A prostate biopsy may be ordered if the physician detects a nodule or other abnormality on the prostate during a digital rectal examination;, a common prostate cancer screening test.

A biopsy also may be ordered when a blood test reveals elevated levels of prostate-specific antigen. While there are several reasons for an elevated PSA level, higher PSA levels are sometimes associated with cancer. PSA trends over time may trigger your physician to order a biopsy.

MRI-guided prostate biopsy may be used in patients who have a rising PSA level yet a negative ultrasound-guided biopsy. It also may be used in situations where a diagnostic prostate MRI performed due to rising PSA demonstrates a very small abnormality that may not be easily targeted by ultrasound. MRI is also useful in patients who have previously undergone a biopsy and want to improve the sensitivity of the procedure and the precision of the biopsy.

A biopsy not only detects cancer; it also provides information on the aggressiveness of the cancer and helps to guide treatment decisions.

Don’t Miss: What Is Neoplasm Of Prostate

What Is Prostate Cancer

Cancer can start any place in the body. Prostate cancer starts in the prostate gland. It starts when cells in the prostate grow out of control.

Cancer cells can spread to other parts of the body. Cancer cells in the prostate can sometimes travel to the bones or other organs and grow there. When cancer cells do this, its called metastasis. To doctors, the cancer cells in the new place look just like the ones from the prostate.

Cancer is always named for the place where it starts. So when prostate cancer spreads to the bones , its still called prostate cancer. Its not called bone cancer unless it starts from cells in the bone.

Ask your doctor to use this picture to show you where your cancer is.

The prostate

The prostate is a gland found only in men, so only men can get prostate cancer.

The prostate is just below the bladder and in front of the rectum . The tube that carries pee goes through the prostate. The prostate makes some of the fluid that helps keep the sperm alive and healthy.

There are a few types of prostate cancer. Some are very rare. Most prostate cancers are a type called adenocarcinoma. This cancer starts from gland cells. Your doctor can tell you more about the type you have.

Prostate Biopsy Specimens: Ask For Meticulous Labeling

The way that prostate biopsy samples are handled varies among hospitals. The samples, or “cores,” are put onto glass slides to be examined under a microscope for signs of cancer. Find out if the physician doing the biopsy will place each core in a separate, labeled container. If cancer is discovered, its location in the prostate gland can affect decisions about further testing and possible treatment.

Individual labeling of biopsy cores is more expensive, and not all hospitals provide this level of service. “If all of the samples from the right and left side of the prostate gland are processed together, as opposed to individually, consider having the biopsy done elsewhere,” Dr. Garnick says.

Recommended Reading: Can You Give Yourself A Prostate Massage