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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.
AAWR: anti-androgen withdrawal response; a decrease in PSA seen upon stopping treatment with an anti-androgen such as Flutamide or Casodex®; this occurs because the anti-androgen has induced a mutation in the androgen receptor (AR) which is allowing the anti-androgen to stimulate rather than inhibit prostate cancer growth.
DOWNSTAGING: the use of hormonal or other forms of management in the attempt to lower the clinical stage of prostate cancer prior to attempted curative treatment (e.g. from stage T3a to stage T2b); this technique is highly controversial
MALIGNANT: cancerous; tending to become progressively worse and to result in death; having the invasive and metastatic (spreading) m properties of cancer.
SPHINCTER: a muscle which surrounds, and by its contraction tends to close, a natural opening; as, the sphincter of the bladder.
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.
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