03rd May 2021
VF Blog: All About Prostate Biopsy
What Is a Prostate Biopsy?
A prostate biopsy is a procedure where small samples of your prostate gland are removed and examined under a microscope after a process to determine the grade (level of agreesiveness) of your prostate cancer. The prostate is a gland right under the bladder and is responsible for making semen.
How Is a Prostate Biopsy Procedure Performed?
There are three routes to access the prostate gland for a biopsy:
The procedure involves the use of a needle in the perineal region to collect tiny bits of your prostate tissue. It is inserted into the skin between the scrotum and the anus, which is also called the perineum. This route is the standard of care which is done under the real-time guidance of an ultrasound probe resting in the rectum. This enables the urologist or an imaging expert to take a biopsy from all the suspicious areas and around the prostate in a thorough, systemized manner.
Here, the needle is passed through the rectal wall with or without the assistance of an ultrasound probe.The ultrasound enables the professional to see the prostate images. Prostate images allow the professional to inject medicine around the prostate to numb you. The rectal route has more chances of you developing post-biopsy infection which at times could be severe.
Next, they insert a biopsy needle and take at least 10 or as many as 30 samples to send to the lab for further examination.
Urologists may utilize different practices, but a common goal is to make the procedure comfortable and painless for you. It can be done with just local anesthesia or general anesthesia or intravenous sedation.
This route for biopsy is not preferred, as the cancer is in the peripheral zone which is far away from the urethra. But this route is common to treat benign enlargement of the prostate causing urinary obstruction
Why Do You Need a Prostate Biopsy?
Your healthcare provider will recommend a prostate biopsy if:
Ø Your PSA (prostate-specific antigen) level is high or has an incremental pattern over a period of time.
Ø They discover a nodule that is suspicious of a cancer on a rectal examination.
How Do You Feel During the Procedure?
It is often expected that you will feel slight discomfort when a professional is inserting the probe. You may also feel a little sting because of the biopsy needle. You can expect some soreness in the rectum or a little blood in your urine, stools, or semen for a few days after the procedure. Recently, there has been a tremendous refinement of the procedure. With the availability of very fine needles and real-time multidimensional ultrasound probes, the procedure is comfortable and almost equivalent to a colonoscopy.
What Are the Risks of Prostate Biopsy?
Even though the procedure is generally considered safe, it is important to be aware of the risks of prostate biopsy. Some of them are:
Ø Blood in urination after biopsy.
Ø High fever with chills and rigors in few patients.
Ø Blood infection.
Ø Bruises or bleeding at the site of biopsy.
Ø Difficulty passing urine.
Ø Medicines causing an allergic reaction.
What Do the Results Indicate?
If your biopsy results come out as normal, it means that there was no indication of cancer cells in the samples taken. However, there is still a chance that you may have cancer that has escaped the targets of the needle. If the result comes out as positive, it may indicate the presence of cancer cells. The lab usually assigns a Gleason score to the cells that predict how fast the cancer is likely to grow.
However, sometimes there may also be abnormal cells shown in a biopsy, but they are not necessarily cancerous. Regardless, the professional will guide you through the next steps.
How to Prepare for the Test
You may be asked to sign a consent form before the procedure is performed. Even though it varies from person to person, you may be told to follow certain guidelines before the days leading to biopsy, such as:
Ø Avoiding any blood-thinning drugs such as aspirin, Warfarin (Coudamin), and ibuprofen like Motrin IB and Advil for many days before the procedure.
Ø Not taking vitamins.
Ø Not taking herbal supplements.
Ø Eating light meals.
Ø Taking anti-biotics a day before your biopsy and an intravenous antibiotic a few hours before the biopsy.
Whether you should choose to have a biopsy or not depends on your health professional’s advice. Make sure to do your research and have a professional consultation before opting for a prostate biopsy.
Image courtesy: Cancer Research UK uploader, CC BY-SA 4.0 , via Wikimedia Commons
Here is another blog post in this series: https://vfrsi.vattikutifoundation.com/blog-about-prostate-cancer
Please note: this blog post is provided for informational purposes and is not intended to replace the guidance of your personal physician. Please consult a medical professional if you have any concerns after reading this or other blog posts on this website.