A prostate biopsy is a procedure that involves taking small samples of prostate tissue to be examined under a microscope to see if there are any cancer cells present. Prostate biopsies are often recommended in response to a rise in prostate-specific antigen (PSA) levels in your blood work. This antigen can be found at low levels in a healthy man’s blood, but rising levels may indicate prostate cancer. However when a doctor recommends a biopsy, it doesn’t automatically mean that there is a high likelihood of cancer. Doctors may seek a biopsy because of a variety of other symptoms, and thanks to modern technology, this procedure can allow for a more accurate diagnosis.
To prepare you for your prostate biopsy, your doctor may have you:
- Stop taking medication that can increase the risk of bleeding, such as warfarin (Coumadin), non-steroidal anti-inflammatory medications (NSAIDs), such as aspirin and ibuprofen (Advil, Motrin, others), and certain herbal supplements for several days before the procedure
- Do a cleansing enema at home before your biopsy appointment
- Take antibiotics 30 to 60 minutes before your prostate biopsy, to help prevent infection.
What To Expect During The Biopsy
This is a fairly quick procedure that takes 10–15 minutes and is often performed in the doctor’s office. The physician may use a transrectal ultrasound, which involves a thin probe that is inserted in the anus, as a guide. The probe uses sound waves to help the doctor accurately direct the numbing agent (if used), and the core needle for the biopsy. The core needle is a spring-loaded instrument that will collect 8–18 prostate samples. Prostate biopsy samples can also be collected in different ways as well. Other types of biopsies include:
- Transurethral biopsy – A long, thin tube equipped with a camera is passed through the opening (urethra) at the tip of the penis in order to access the prostate.
- Transperineal biopsy – This type of prostate biopsy involves making a small incision in the area of skin (perineum) between the anus and the scrotum. The doctor then inserts a biopsy needle through the cut and into the prostate to draw out a sample of tissue.
After The Procedure
After the procedure, you should drink plenty of water, avoid heavy lifting for 24 hours, and avoid straining during bowel movements for 48 hours. The expected short-term side effects include soreness, blood in the urine, light rectal bleeding, and blood in the semen. You should contact your doctor if you experience difficulty or pain while urinating, heavy or ongoing bleeding, increasing pain, swelling, fever, or penile discharge.
A pathologist will examine the prostate samples collected during the biopsy; this lab work may take a few days to a week to complete. If cancer is detected, the pathologist will detail the grade and structure of the cancer, and your doctor will help you identify the next steps in treatment. If cancer is not identified, your PSA levels will continue to be monitored at regular intervals. If they continue to rise, another biopsy may be recommended again at a later date.