Prostate Problem Guide
Prostate Biopsy Procedure - What You Should Expect
Although the prostate specific antigen, or PSA, test and the digital rectal examination, or DRE, can indicate the possible presence of prostate cancer, the only way to make a positive diagnosis is through a prostate biopsy.
So, for people who have been identified as being at high risk from prostate cancer the prostate biopsy is an essential test and, while many men tend to fear the procedure and to put it off as long as possible, this fear is really more imagined than real.
Most men report that the prostate biopsy is a relatively painless procedure and only a very small number of men report pain following the procedure. This said, it is fair to say that a prostate biopsy is an uncomfortable procedure.
There are various prostate biopsy procedures in use today and perhaps the most common procedure is the core needle biopsy. Here several very small tissue samples are removed from the prostrate gland using a biopsy gun which fires a needle into the area from which the sample is to be taken and removes the required sample in a fraction of a second. The samples collected are then analyzed in a laboratory to see whether cancer is present and, if it is, to assess just how much of the prostate gland is affected.
CONCORDANCE: the agreement in findings that support the accuracy of a particular investigation or treatment; concordance is a critical concept in studies to diagnose, stage and treat prostate cancer.
HYPERSENSITIVE PSA (ULTRASENSITIVE PSA): a laboratory assay for PSA that is more sensitive to detection of low levels of PSA than a standard assay; these assays allow for earlier detection of recurrence and can distinguish an excellent response to ADT from a mediocre response; Dprostate cancer Immulite 3rd generation and Tosoh are two examples of hypersensitive PSA assays available.
PLACEBO: a form of safe but non-active treatment frequently used as a basis for comparison with pharmaceuticals in research studies.
SARM (SELECTIVE ANDROGEN RECEPTOR MODULATOR): a drug that selectively inhibits androgen receptors of a specific tissue(s) while allowing the normal interaction of the androgen with androgen receptors at other sites.
In the majority of cases the prostate gland is accessed through the wall of the rectum as this offers relatively easy access to the prostate gland. This procedure, which is normally carried out under local anesthetic, takes about 30 minutes.
In other cases the prostate is accessed through the urethra, which passes through the prostate gland. Here a lighted scope which incorporates a small cutting loop is inserted into the urethra and the samples are again collected under local anesthetic (or occasionally under general anesthetic) in a procedure that takes between 30 and 45 minutes.
A less common option is to collect samples through the perineum, which is the area that lies between the anus and the scrotum. Here the urologist uses a finger inserted into the rectum to hold the prostate gland still and inserts the biopsy needle through a small incision in the perineum. This procedure is again carried out under local anesthetic (or again occasionally under general anesthetic) and takes about 15 minutes.