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Biopsy is the standard diagnostic technique for the detection of prostate cancer. The doctor orders it based on various factors, including the results of other tests. A biopsy removes samples of suspicious tissue from the prostate. They are then carefully examined under a microscope to detect cancerous cells. The prostate is a small walnut-shaped gland in men. It produces a fluid that nourishes and transports the sperm.
What are the advantages and disadvantages of a prostate biopsy?
Your doctor should talk to you about the pros and cons of this diagnostic method. If you have any doubts or additional questions, be sure to discuss this with your specialist before deciding to have a biopsy.
Advantages of a prostate biopsy
A biopsy (TRUST) is much more effective than the prostate specific antigen (PSA) test. It is performed under the control of ultrasound (USG). Samples collected from the prostate gland are then sent to a specialized laboratory and checked for the presence or absence of prostate cancer.
Although ultrasound images cannot visualize the tumors themselves, the use of advanced multi-parameter magnetic resonance imaging (MRI) in conjunction with a TRUST biopsy is of clinical importance.
Disadvantages of prostate biopsy
One of the major drawbacks is that the TRUST biopsy has a false negative rate of 30%. Primarily because samples are generally taken blindly due to an unknown tumor area. However, a standard biopsy is only 53% effective.
Therefore, despite the false positives, if primary symptoms persist, or if PSA levels are high or rising, the test should be repeated.
Prostate biopsy – basic indications
A prostate biopsy is used to detect prostate cancer. Your doctor may order it when:
- PSA result is elevated,
- noticed lumps or other abnormalities on a digital rectal exam (DRE)
- previous biopsy results were normal, but PSA was not normal and / or there were distressing symptoms,
- previous biopsy revealed abnormal but not cancerous cells in prostate tissue.
What is a TRUST biopsy?
The doctor uses a fine needle to take small samples of tissue from the prostate. During the examination, the patient lies on his side on the table, with his knees raised towards his chest. The specialist will place the probe in the rectum using the gel so as not to cause discomfort. It uses ultrasound to indicate where it is getting the cells from. If you have an MRI scan, your doctor may use the photos to decide which areas to take samples from.
You’ll get a local anesthetic injection. Usually, a specialist takes 10-12 tissue samples from different areas of the prostate. However, if he uses ultrasound or MRI, he may retrieve fewer of them.
The biopsy usually takes 5-10 minutes.
After the examination, your doctor may ask you to urinate before you return home. In this way, he will check if there is any swelling of the prostate hindering the functioning of the urinary system.
Check: What are the symptoms of prostatitis?
Transperineal biopsy
During the procedure, the doctor inserts a needle into the prostate gland through the skin between the testicles and the perineum. It is usually performed under general anesthesia. So you will be asleep and feel nothing.
Usually a transperineal biopsy takes 20-40 minutes.
If you’ve had an MRI, the specialist may simply take a few samples from suspicious locations. This is called targeted biopsy. Your doctor may also decide to collect up to 25 samples from different areas of the prostate.