Prostate biopsy
What is prostate biopsy?
Prostate biopsy involves obtaining tissue samples from the prostate gland to investigate and diagnose prostate cancer. Generally this biopsy is done with the use of a special ultrasound machine.
The biopsy could be performed either under local anaesthesia or general anaesthesia. Nowadays, it is becoming more and more common to have this procedure under general anaesthetic. This is because, to improve the yield of the biopsy, the number of samples to be obtained has increased from six to up to 24 samples.
The biopsies are obtained from patient’s back passage. Although the prostate gland sits at the opening of the urinary bladder, it is more easily accessible from the rectal region. Moreover, more than 75% of prostate cancers tend to originate in the peripheral zone of the prostate, which is in the vicinity of the rectum.
Common questions about prostate biopsy
Is it possible for my prostate cancer to spread to the rectum after prostate biopsy?
Although there are certain types of cancers which do carry a risk of “cancer cell implantation” and a biopsy of such cancers may carry some risk of initiating new tumours, there is no such risk of prostate cancer spreading in this manner.
What are the side effects?
The common side effects after prostate biopsy are urinary bleeding, bleeding from the back passage, urinary difficulty, and noticing blood in the semen. These symptoms are usually self limiting and resolve within 48-72 hours. However, one may notice brown coloured semen (altered blood) for up to a few weeks to a few months. This is an entirely harmless event for the patient as well as his partner.
There is always a possibility of developing urine infection following the biopsy. Generally this infection can be prevented by prophylactic antibiotics. About 1-2% of men undergoing prostate biopsy can acquire urinary infection requiring hospitalisation.
The other possible side effect would be urinary blockage which usually occurs as a result of reactionary swelling of the prostate gland. With this problem, one may have to have a urinary catheter inserted for a short period (a few hours to 2-3 days).
What should I do if my temperature is elevated?
Flu-like symptoms are not uncommon after prostate biopsy. However, if at any stage if you develop high fever, rigors or chills, you should contact your local doctor, proceduralist, or the emergency department of Manning Rural Referral Hospital. These are the signs of systemic infection and need to be treated with injectable antibiotics.
When will my biopsy results be available?
In a routine scenario, prostate biopsy results could be available in as early as 72 hours. However, on a few occasions, the pathologist may not be able to confirm the diagnosis with routine tests. In this case he or she will run a few more “staining” tests on the biopsy sample and if necessary may send the sample to another pathologist, in which case it may take a few days to obtain the final result. Therefore, generally biopsy results are discussed with you after 10 days.
Can I bring my wife or partner with me to discuss the results?
Yes. In fact, it is always recommended you have your partner or a close friend accompanying you at your discussion with the doctor. If your results are not favourable then you may not be able to register part of the important discussion your doctor will have with you in regards to planning the treatment. In such a case, the accompanying person would be able to gather more information which could help you later.
Moreso, it is equally important for your wife or partner to be involved in the decision making for treating your prostate cancer.
I already had a prostate biopsy, why do I have to have it again?
The prostate is a gland which may weigh anywhere between 20 grams to more than 100 grams. Sometimes a small focus of cancer sitting in a corner of the prostate may be missed. Also if one’s prostate is large, the biopsy needle may not reach adequate distances to cover the entire gland. If clinically indicated, your doctor will repeat a prostate biopsy within 6-12 months.
If my biopsy is benign, does it mean I am free of cancer?
As described in the above answer, the prostate is a gland which may weigh anywhere between 20 to more than 100 grams. Sometimes a small focus of cancer sitting in a corner of the prostate may be missed. Also if one’s prostate is large, the biopsy needle may not reach adequate distances to cover the entire gland.
What precautions should I take before and after the biopsy?
- Make sure that you stop any blood thinning medications (Aspirin/ Plavix/ Cartia for 10 days and Warfarin/ Coumadin for 5 days) before the procedure.
- Do not forget to take antibiotics 6 hours before the procedure.
- You should be coming with an empty stomach but you are allowed to take these tablets along with a sip of water.
- If you have sluggish bowels, it is advisable to take some mild laxatives at night before the procedure.
- Do not make any travel plans at least for 48 hours after the biopsy.
- Please be sure to make an appointment to see Dr Nagaonkar in 10 days time.
