When Should You Get a Prostate Biopsy?

3 min read

When Should You Get a Prostate Biopsy?

Prostate cancer is one of the most common types of cancer in men. If a biopsy of the prostate is recommended, there are either symptoms present that could be related to cancer, or screening test results show signs that cancer may be present. 

The information gathered in a prostate biopsy is important in deciding if cancer is present, whether treatment is needed, and if so, what type of treatment is right for you. Let’s take a look at what a prostate biopsy is, how it’s performed and who needs to have this procedure.

What is a Prostate Biopsy?

A prostate biopsy is a medical procedure in which tissue samples are collected from your prostate gland. The goal is to determine whether or not cancer cells exist within the prostate. During a prostate biopsy, several small tissue samples are removed from the prostate and examined. The tissue is collected using two methods: needle aspiration or surgical extraction. 

In a needle aspiration, an instrument called a core needle is inserted into your rectum and used to extract tissue samples from your prostate gland. Several samples are taken to see how the cells look in a few areas of the prostate. Your doctor will inject an anesthetic before performing a needle biopsy to reduce pain during the extraction. 

A surgical extraction involves making a small incision in your abdomen and inserting a tool called an endoscope into your rectum. Once inside, it’s guided through your urethra until it reaches your prostate gland; at that point, multiple tissue samples (often 10-12) are extracted with forceps. This is not performed as often but is the right choice for some patients.

Why is a Prostate Biopsy Recommended?

Your doctor will likely order a prostate biopsy if your PSA levels have risen steadily for a year without finding another cause for the increase. A biopsy may also be recommended if prostate cancer symptoms are present with no other known cause including difficulty urinating, painful urination, blood in the urine or semen, unexplained fatigue, and back pain. 

Some men have a repeat biopsy performed every few years if they’re under “watchful waiting” to see if the cancer has grown. A biopsy is the most sure way of knowing if there has been growth and whether it’s time to take steps towards treatment. 

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How is Prostate Cancer Diagnosed?

A pathologist will review the tissue samples and create a biopsy report that states whether cancer is present. If cancer is found, a grade and Gleason score are determined as well. This information, when given to an oncologist, will help determine the stage of cancer and the timing of treatments.

Additional tests may need to be run to determine if the cancer has moved outside of the prostate. 

Is Prostate Cancer Screening Different from a Biopsy?

Routine screening for prostate cancer is recommended for all men starting at age 50. If prostate cancer is found early, it’s easier to treat and outcomes are usually better.

For men who have a higher risk level, you might start as early as age 40. Risk factors include having a first-degree relative who has been diagnosed with prostate cancer, being African-American, or having a known genetic mutation associated with prostate cancer.

Screening is not the same as a biopsy. Screening tests include a PSA blood test to see if your prostate-specific antigen levels are above normal as well as a physical exam. A biopsy is only recommended if there are signs that cancer could be growing and non-cancerous conditions are ruled out. Biopsies are usually performed by a urologist in an outpatient setting.

What Happens if the Biopsy Report Shows Cancer is Present?

The best thing to do is talk with an oncologist who specializes in treating prostate cancer. There are a lot of directions that prostate cancer treatment can go, but what’s best for you and your personal goals can be discussed and a treatment plan developed around that. Many men don’t need to start treatments immediately, but rather will be under the watchful eye of the oncologist who will run tests every 6-12 months to determine if the cancer has grown to the point that treatment should begin.

Seeing the experts at Radiotherapy Clinics of Georgia after a prostate cancer diagnosis will give you a better idea of what treatment might look like for you based on your biopsy results. It is important to understand all of the options available to you, and the potential side effects of each approach. Request a consultation with one of our Atlanta-area prostate cancer specialists if you’ve received a prostate cancer diagnosis and would like to discuss what’s best for you.

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