Prostate biopsy

A prostate biopsy does not necessarily mean you have cancer. Learn more about the procedure and why it may be recommended.

Why get a prostate biopsy?

Having a prostate biopsy does not necessarily mean you have cancer. In fact, it can be used to eliminate cancer as the cause of your prostate issues.

This procedure is known as a transrectal ultrasound (TRUS) with prostate biopsy. Ultrasound uses high-frequency sound waves to create an image. This image lets us see and measure the prostate and guides the doctor to specific tissues from which to take samples.

Your urologist may recommend a biopsy if you:

  • Have an elevated or changing PSA (prostate-specific antigen) number in a blood test
  • Have lumps or other abnormalities during a digital rectal exam
  • Have had a previous biopsy that was normal, but you still have elevated PSA levels
  • Other conditions about which your urologist may be concerned

How the procedure is performed

The procedure will take place at The Urology Center in Norwood, Ohio. You will need someone to drive you home after the procedure, unless you are not having anesthesia/sedation.

Here is a general description of the procedure:

  • You will be given antibiotics to prevent infection.
  • You will be asked to lie on your side with your knees pulled up to your chest.
  • If you are not given anesthesia, the area in which the biopsy is done will be lightly numbed to reduce any discomfort.
  • During the biopsy, a needle is passed through the rectal tissue to collect several samples from your prostate gland.
  • Small tissue samples taken during the biopsy are sent to our pathology lab for analysis. Generally, 12 samples are taken.

Once you are prepped, the entire procedure is usually completed in 10-15 minutes.

 

Click here for more information, including pre-op instructions and post-op expectations.

Test results

One of our pathologists will evaluate your prostate biopsy samples, determine if cancer is present, and estimate how aggressive it is. Someone will call you with results or to schedule an office visit within 10 business days of your biopsy.

Your pathology report will typically include:

  • Diagnosis and description of cells. This part of the report will describe the way the cells appear under the microscope. Cancerous cells are often defined as adenocarcinoma. Normal tissue is referred to as benign.
  • Cancer grading. If cells are considered cancerous, they are graded on a scale of 6 to 10, called the Gleason score. Cancers with a high Gleason score are the most abnormal and are more likely to grow and spread.

Additional testing

Depending on your situation, your urologist may order additional testing related to your biopsy. This is sometimes determined after you have left your office appointment.

Here are some common types of additional testing:

Prostate MRI or MRI fusion biopsy

If you have had a prior prostate biopsy then we will request that you schedule an MRI of your prostate before the biopsy. This provides a different type of imaging that looks for abnormal areas in your prostate.

MRI/ultrasound fusion technology allows the urologist to match the MRI images to the ultrasound images and mark the biopsy targets. This subsequently allows direct sampling of any suspicious areas.

Know Error® DNA test

We recommend that all prostate biopsy patients receive this pre-procedure test. A cheek swab will be taken from your mouth at the time of the biopsy. If you are found to have cancer in a biopsy, the DNA from your cheek will be used to confirm that the biopsy matches your DNA. The informed consent form will be given to you to sign prior to the biopsy.

Molecular testing on prostate biopsies

Your physician may order molecular tests on your biopsy tissue. You will receive a call from our Navigation Department to discuss the test.

  • If your biopsy is NEGATIVE for cancer, ConfirmMDx is a test to determine risk of undiscovered prostate cancer. This can help determine if you need further testing.
  • If your biopsy is POSITIVE for cancer, Decipher®, OncotypeDX® or Prolaris® testing determines the aggressiveness of your cancer. This may help to decide the best course of treatment for you.

Click here for more information, including information about billing for additional testing.

Medications to avoid

If you are scheduled for a prostate biopsy, you should avoid taking certain medications.

Below is a partial list of medications you may be asked to discontinue before your procedure (click here for a complete list). Let the scheduler know if you are currently taking any of these medications when he or she calls. You may need to check with your prescribing doctor before stopping these medications.

Apixaban (Eliquis)

Aspirin

Cliostazol (Pletal)

Clopidrogel (Plavix)

Dabigatran (Pradaxa)

Fish oil

Heparin (various)

Ibuprofen

Prasugrel (Effient)

Rivaroxaban (Xarelto)

Ticagrelor (Brilinta)

Vitamin E

Warfarin (Coumadin)

 

 

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