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How Prostate Cancer

is Diagnosed Information provided by The Prostate Cancer Foundation

Hopefully you're a sensible guy who goes for your However the diagnosis of prostate cancer can only be
annual medical check-up and you're aware of the made based on the results of a prostate biopsy, so
importance of screening for prostate cancer. If you are, although an MRI is useful, it is not mandatory.
and you're a black guy black over the age of 40 then
you'll be having a PSA blood test every year, and ideally The prostate biopsy
a digital rectal examination. All other guys should start This is the procedure that is used to diagnose prostate
screening from the age of 45. PSA stands for prostate cancer. Sometimes it's done in theatre under general
specific antigen, which is a type of protein that enters the anaesthetic and sometimes it's done under local
blood when the barriers in the prostate are damaged. It anaesthetic. It involves extracting tissue samples from
is not a cancer specific test so a high score doesn't the prostate using special thin hollow biopsy needles.
necessarily mean that you have prostate cancer. There are two different areas where the needles can be
If your PSA test is high or your doctor feels anything inserted for a prostate biopsy. Both involve using an
abnormal when doing a digital rectal examination, or you ultrasound probe inserted into the rectum which provides
have any signs and symptoms of prostate cancer, you'll a live image of the prostate. This enables the urologist to
be referred to a urologist. Urologists are medical doctors see where the biopsy needles are being inserted in the
who have specialised in conditions involving the male prostate.
and female urinary tract. They also specialise in the
male reproductive system, so they are about the closest
equivalent to a “men's health specialist” that you get. Transperineal biopsy
The urologist will normally take a thorough history and For a transperineal biopsy, the needles are inserted
will do a digital rectal examination. You may also be through the perineum (the area between the scrotum &
referred for another PSA blood test to confirm the the anus) after a small cut is made. There is less risk of
results. There are somethings that you should avoid for infection with this procedure compared to a transrectal
48 hours before a PSA test as they can affect the biopsy. The procedure is however more painful than a
results. These include; cycling, ejaculation and a digital transrectal biopsy.
Rectal Examination (DRE). If your urologist suspects
that your PSA is high because of an infection of the Transrectal biopsy
prostate you may be prescribed antibiotics and then the For a transrectal biopsy the needles are inserted through
PSA will be repeated. Depending on affordability and the rectum. There is obviously a higher risk of infection
availability, many urologists will send you for a special from transrectal biopsies, as bacteria from the rectum
kind of scan called a multi-parametric MRI (mpMRI) can be transferred via the biopsy needle to the urinary
scan, which helps to identify suspicious areas in the tract or blood circulation. To reduce the risk of infection
prostate that suggest prostate cancer may be present.
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