How is a Prostate Biopsy Performed?

So we’ve decided to do a biopsy so what does this mean well the Bostick biopsy right now still is the only definitive way of knowing whether there’s a focus of cancer. We can potentially use other modalities, we’re looking at MRIs, we can look at areas on the ultrasound which may look suspicious, but the only way to diagnose whether there’s a focus of cancer is to actually get a specific tissue biopsy,

And under that biopsy a pathologist will diagnose that as prostate cancer.The prostate biopsy itself routinely takes maybe 10 15 minutes on the outside, and it’s very important that you talk to your Medical General Practitioner, just to make sure that he’s actually doing a specific type of anesthesia which can numb up around the prostate. Sure it’s no fun having the ultrasound probe in the rectum. I get that, but at the end of the day, is that that’s routinely not that bad. You have the ultrasound in there, routinely the probes are very small these days.

The next important thing is to make sure that we’re anesthetized numbing up around the prostate. Once we numb up the prostate, we then take small little snippets of that prostate. The way we do this is a prostate biopsy needle, and that needle actually will be directed into specific areas of this prostate. So we look at the front of the prostate, the middle of the prostate and the back side of the prostate. It’s also known as the apex, the mid and the base of the prostate, and depending if we actually see any areas that look suspicious in those zones, will depend on where we actually target those needles.

In that particular area when we put those needles in, we do want to make sure that the patient is comfortable, which makes it very very important the fact that we’ve actually numbed up around the prostate. Most patients, if they’ve actually been numbed appropriately, will feel a little bit of pressure. Almost like a thump. May be a very very minimal for the most part, but it’s really very minimal,

Actually we’ve done significantly better work on this over the last 10 years as urologist, so most men undergoing a biopsy now really should have minimal discomfort associated with this the big pump of complaint that actually patients have.

Unfortunately, they can actually hear the biopsy needle firing off, so they hear a snap, and I routinely tell them you’re here oh snap, and then they say well I didn’t feel anything. I just heard the snap, that’s the worst part about that. Then, it should be what we do is we actually take all those small little insertions, so that needle will go off, and what it does it takes about a two centimeter. Small little area,I tell patients it looks almost like it’s about the length and a half of a toothpick, and that goes actually over to the pathologist. They actually look at that specimen and then once that biopsy, (all those specimens they’re actually collected into a jar)  they’re sent to the pathologist, and the pathologist then will come back to us and let us know is there cancer. If there not cancer or are there other areas that are non cancerous but are potentially suspicious or that pathologists will then look at those specimens, and let us know.

Is there cancer, is there no cancer, or are there any abnormalities in that tissue that would require us to potentially either do more biopsies, or have a further look at that specimen that we recently took that biopsy. Some prostate cancers are high risk aggressive and more likely to spread. Ohers are low risk, least likely to have bad outcomes. The biopsy says cancer, but current diagnostic tools provide limited information about how aggressive a man’s individual disease is, so most men decide to treat prostate cancer immediately.

Once treated, many men experience serious long-term side effects, like incontinence and sexual impotence. Immediate treatment is not always needed, but right now a man can’t be sure if his cancer is the kind that is likely to require treatment or if he is okay to wait for now. What if there was a test that could determine how aggressive prostate cancer is?  Genomic health is developing a new test to do just that, by reviewing the underlying biology of the tumor and using genes from multiple biologic pathways, the test can predict the aggressiveness of prostate cancer when diagnosed, allowing a man to make a more informed treatment decision with confidence taking care of himself with more information and greater peace of mind ,

How is a Prostate Biopsy Performed?
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