Is the Prostate Cancer Biopsy an Effective Diagnostic Tool?

Despite the fact that there are various different tests that can be undertaken if you suspect the presence of prostate cancer, the only sure way to detect the condition is through a prostate cancer biopsy. But precisely how successful is the biopsy when it comes to confirming this disease?

In the US alone every year there are in the region of one million prostate cancer biopsy procedures performed of which around 25 percent indicate the existence of prostate cancer. Of the remaining 75 percent of prostate biopsies however about one-third indicate false negative results. This means that roughly 25 percent of all men being subjected to a prostate biopsy are cleared by this test, despite the fact that they have prostate cancer.

On the face of it therefore it may appear that the prostate cancer biopsy is not a very effective test but the results do not show that there is anything wrong with the prostate biopsy procedure as a means of diagnosing the presence of prostate cancer. What it does clearly mean however is that there is a need to detect those individuals who, in spite of they have returned a negative result, are nevertheless at high risk from prostate cancer and ought therefore to undergo a second follow-up biopsy.

The problem is that until very recently there has been no easy method of determining those patients at risk. However, a study of more than 500 patients being investigated for the presence of prostate cancer may now provide a solution.

All of the individuals investigated in the study had already received a negative prostate biopsy result but the researchers discovered that when they looked at the patient’s prostate specific antigen (PSA) test results and these were adjusted to take account of the size of the prostate gland they were able to identify those individuals who were likely to return positive results on a second biopsy.

The researchers also found that men with a Gleeson score of 7 or more were at an increased risk from life-threatening prostate cancer and were again more likely to receive a positive result from a further biopsy. The Gleeson score is measured on a scale between 2 and 10 and the score is calculated from a laboratory investigation of the prostate biopsy tissue. Low scores indicate cancer with a relatively low risk of spread and high scores indicate cancer which is more likely to spread.

There are various different prostate biopsy procedures available nowadays although perhaps the most often used procedure is known as the core needle biopsy. In this case a number of tiny tissue samples are removed from different areas of the prostrate gland with a biopsy gun which shoots a needle into the selected section to remove the sample within a fraction of a second. These samples are then sent off for microscopic analysis to ascertain whether or not cancer is present and, if it is, to work out precisely how much of the prostate gland is affected.

A prostate cancer biopsy is a costly procedure and is a test which can be reasonably distressing for the subject. It is sometimes also a quite painful procedure which can be accompanied by bleeding and the risk of infection. Consequently it is important to identify those patients for whom a follow-up biopsy would be wise and to reduce as far as possible the number of needless follow-up biopsies being done every year.

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