As long as you are receiving annual digital rectal exams and additional prostate-specific antigen (PSA) blood tests, you should be ahead of the game when it comes to detecting potential prostate issues. But if one of these tests indicates that there may be cancer present in the prostate, a prostate biopsy will be the next step. From there, the doctor will be able to effectively diagnose the specific type of cancer and create a treatment plan. A biopsy is required in order to diagnose prostate cancer.
What Is a Prostate Biopsy?
If you have received abnormal results during a digital rectal exam or from a PSA blood test, and you are experiencing some of the following symptoms, your doctor may opt to perform a prostate biopsy:
- Frequent urination, especially at night (nocturia)
- Painful urination
- Difficulty urinating or a weak urine stream
- Blood in the urine or semen
- Erectile dysfunction
These symptoms themselves are not a cause for immediate suspicion of prostate cancer. However, coupled with an abnormal prostate test, they can indicate something more serious. As with any type of test, there can be false-positives or false-negatives, so a prostate biopsy serves as an added layer of confirmation.
Just like biopsies in any other part of the body, a prostate biopsy removes a small piece of tissue from the affected area in the prostate gland. This tissue sample is then sent to a lab to be tested for prostate cancer. A pathology report with the results of this testing typically comes back within a week.
Roughly 1 in 9 men will have prostate cancer in his lifetime. If caught early, prostate cancer can be effectively treated. In fact, the death rate among men with prostate cancer is 1 in 41. The majority of cases are detected while the cancer is in its early stages, so it can be treated, and most men go on to lead normal, healthy lives post-treatment. If cancer has spread beyond the prostate, this could mean additional complications, which is why early detection through yearly prostate exams is so important.
What Should I Expect During a Prostate Biopsy?
The prostate biopsy procedure is done in our office and takes somewhere between 10 and 30 minutes. A local anesthesia is used for numbing, so you will be conscious but not in pain. The doctor will insert a needle into the prostate, either by way of the rectum, the scrotum, or the urethra — whichever area is closest to the site of the affected tissue.
While this needle is inserted, the doctor will be guiding it to the biopsy site using a transrectal ultrasound to view the area. The needle includes a surgical tool for collecting cylindrical bits of prostate tissue (called “cores”.) Between two and fifteen of these tissue cores will be retrieved during the biopsy, depending how much of the area we need to test.
Each sample is taken in under one second, so the procedure itself is actually quite quick. Once the tissue samples are taken, the doctor will examine them under a microscope, and then the cores are sent out to a lab for further testing.
Prior to the biopsy, the doctor may ask you to use an enema. Typically, fasting is not required unless general anesthesia will be used, in which case you would remain unconscious for the duration of the procedure.
We prefer that someone accompany you to the appointment to drive you home afterward, and we require this if sedatives are used.
What Is the Recovery Time?
After the procedure, the doctor may prescribe an antibiotic to prevent infection and will give recommendations for pain medications. It is important to only take recommended or prescribed medications, as others may increase bleeding.
Immediately following the biopsy, you may feel urinary or bowel urges, which will pass within a few hours. You will likely have some soreness in the rectal area, but this should subside within a few days. Light bleeding, or traces of blood in the stool, urine, or semen, is also normal.
You may resume normal physical activity and will be able to work following the biopsy, as you feel comfortable. Some men find that taking a day or two off from exercising is necessary. The biopsy will not interfere with the ability to get an erection.
Contact your doctor if you experience any of the following symptoms after the biopsy:
- Heavy bleeding or bleeding that continues after the first several days post-procedure
- Pelvic or abdominal pain
- Burning sensations when urinating
- Foul-smelling urine
- Inability to urinate
Just because the doctor may order a prostate biopsy does not automatically mean cause for alarm. Many times, this is a step to rule out a prostate cancer diagnosis. If you are experiencing symptoms that could be related to a urological issue, give us a call to make an appointment with one of our specialists. And remember that the best way to prevent a late-stage prostate cancer diagnosis is through regular screenings during your annual prostate exam.