Prostate cancer starts with enlargement in prostate gland ( as you can see in the picture).Prostate cancer may be first recognized by decreased urine flow and may spread to other organs like bones and lungs if it is not diagnosed and treated early. Some different ways are used and studied for prostate cancer diagnosis but prostate biopsy is still the best method for diagnosis. Urologist may request prostate biopsy if the PSA and other screening test results are suspected. (See. PSA Test )
Preparation for prostate biopsy
You must stop using blood thinners like aspirin at least 1 week before the prostate biopsy. These kind of medication may increase bleeding risk so please don’t use them 1 week before and after the prostate biopsy.
Prostate biopsy may be postponed if there is an infection in urinary tract. Your doctor may give you some antibiotics against infection, also antibiotic usage will be protective for post biopsy term.
You will need to have one enema to empty your colon and reduce infection risk before the procedure
How the prostate biopsy is done?
You’ll need to lie on your left side and pull your knees to your chest. A local anesthetic is applied to prevent pain. A thin ultrasound probe will be inserted through your rectum and your doctor will collect 6-12 small parts of tissue from your prostate with a needle. Ultrasound helps the specialist and makes prostate gland more visible during the procedure. All procedure takes 15-20 minutes at most.
Risks of prostate biopsy
You may have low blood pressure and you may feel dizziness after the prostate biopsy process so you may need to rest in the clinic for a short time. There can be blood in the stool, urine or semen after the process or your semen may be rust colored. These symptoms disappear in a few weeks. If you have prolonged and much bleeding please consult your doctor.
Urinary tract infection (See. Urinary tract infections (UTI)) and prostatitis are another risks of prostate biopsy. Your doctor will prescript you some antibiotics to prevent infection. You may have symptoms of prostatitis (inflammation of prostate gland) like fever, chills, difficulty urinating; please inform your doctor about the symptoms.
After the prostate biopsy
- Take plenty of water and other liquids
- Prefer high fiber foods to prevent constipation
- Use your antibiotics regular as your doctor or pharmacist told you
Evaluation of prostate biopsy
Urologist sends the biopsy samples to the pathology lab, the samples are colored with special dyes and looked under the microscope. Pathologist will analyze the sample to find any cancer cells. If any cancer cells are found, it is important to know the type and grade of cancer.
Negative and positive prostate biopsy results
Positive result means prostate cancer but negative result does not always mean that there is no cancer. At least 6-12 biopsy samples are collected but they may not contain cancer cells so the result will be negative.
Gleason score; grade of prostate cancer
Prostate cancer is graded according to the pathologist’s report as 2 to 10 and this is called Gleason score. 2 is the lowest risk and the risk increases up to 10. Gleason score 10 is the most aggressive cancer type. Prostate cancer treatment will be planned according to the risk that is found by gleason score, PSA result and digital rectal examination.