Prostate cancer is the second most common form of cancer in American men, with newly diagnosed cases topping 190,000 each year. While a prostate cancer diagnosis can be extremely scary, survival rates for the disease are actually quite high. Proper detection is a key component in attaining such successful treatment outcomes, and prostate biopsy is the definitive method for achieving accurate testing results.
Preliminary Testing
Typically a urologist, or specialist in men's urinary and sexual organs, will perform a biopsy. He may perform a digital rectal exam, or a special blood test that will measure the presence of prostate-specific antigens (PSAs); heightened amounts of these antigens are indicators for cancer. If the digital exam reveals lumps on the prostate, or if the PSA count is elevated, he will schedule a biopsy to directly test for the presence of prostate cancer.
Preparing for Biopsy
Before a prostate biopsy, there are certain preparations you should take. Approximately a week prior to the procedure, you will need to stop taking any non-steroidal anti-inflammatory (NSAID) medications like ibuprofen or aspirin. Additionally, you should stop taking warfarin (Coumadin), or any other compound that affects blood clotting. Your urologist may also ask you to discontinue herbal supplementation.
Due to the nature of the procedure, infection risk from fecal matter is a concern, and your urologist may ask you to perform a home enema the day of your biopsy. He may also have you take antibiotics to further diminish infection possibilities.
As indicated in the previous paragraph, it is likely your urologist will perform a transrectal biopsy, using a special needle to pass directly through the wall of your rectum. In some cases, he may prefer to access the prostate through your perineum (the flesh between your scrotum and anus) or urethra (via the tip of your penis).
The Biopsy
If your urologist performs a transrectal biopsy, he will have you lie in a tucked position to afford him proper access. He will then sanitize the site of the biopsy and apply a topical numbing agent. Before starting the actual biopsy, he will insert an imaging device into your rectum which will allow him to get an ultrasound picture of your prostate. Once he sees exactly how your prostate is positioned, he will begin the biopsy.
Using a thin, hollow spring-loaded needle, he will push through the rectum wall to the prostate. Once he has reached the prostate, he will use the spring-loading mechanism to take 10 to 12 small tissue samples. It is likely you will feel some degree of pain with each injection. The entire procedure typically lasts no more than 30 minutes.
Aftermath
In the aftermath of the biopsy you may experience some common temporary after effects, including slight rectal bleeding, soreness, and blood in the urine, stool or semen. Consult your urologist for complete aftercare guidelines, including ways to monitor potential signs of longer-lasting or more serious complications.
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