How Is a Prostate Needle Biopsy Performed?
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When It's Needed
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Patients will be referred for a prostate needle biopsy if there is suspected prostate cancer. This could be because of elevated prostate-specific antigen (PSA) levels, changes in the size of the prostate, or growths felt in or around the gland. A needle biopsy is the least invasive way of diagnosing cancerous cells.
Pre-surgical
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About a week prior to surgery, patients are asked to stop taking anti-inflammatories and asprin to limit bleeding risk. Blood work is ordered to check for any other illness and gauge PSA levels. A pre-surgical exam by an internist may be required, depending on the man's health and if there are chronic conditions (heart disease, diabetes) present. An enema is often recommended, since most needle biopsies are done with transrectal (through the rectum) ultrasound. Some physicians also recommend antibiotics prior to the biopsy to help protect against infection.
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Procedure
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A prostate needle biopsy is usually performed at the office of a urologist. A local anesthesia is given to numb the area. Some patients are also sedated. Transrectal ultrasound is used to help guide the needle via an image of the prostate on a screen. The "biopsy gun" enters the wall of the rectum until it reaches the part of the prostate gland that is suspected to be abnormal. On the average, a physician will take six tissue samples to be examined by a pathologist.
Post-surgical
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After the biopsy is complete, the pathologist will examine the tissue under a microscope to check for cancerous cells. Most results will be available immediately, though additional testing may be needed. If malignancy is found, the cancer will be staged based on its location and the appearance of the cells. Treatment options will be discussed between doctor and patient. Prostate cancer is often curable when detected in its earliest stages. There are many treatment options (surgery, radiation, chemotherapy) available to prostate cancer patients.
Complications
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The patient may experience minor bleeding after the prostate needle biopsy. There could be a small amount of blood in the bowel, semen and urine for the following days. Serious complications (excess bleeding, infection) are rare.
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