Prostate Biopsy: What You Need to Know

Any man moving into his 40s will want to start talking with his doctor about a prostate biopsy. Prostate cancer is the second-most-common type of cancer in American men, and it's most often found in men aged 65 or older. It's something to keep an eye on, especially if you have direct family history.

A prostate biopsy is the diagnostic procedure used to determine whether cancer exists in the prostate. When a doctor recommends a biopsy, this does not automatically mean that there is a high likelihood of cancer. Doctors may seek a biopsy because of a variety of symptoms, and thanks to modern technology, this procedure can result in a very accurate diagnosis.

Why Do I Need a Prostate Biopsy?

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. The PSA level at which doctors recommend biopsy may vary by doctor and the patient's family health history. Some men are diagnosed with prostate cancer when their PSA levels are below four; if the PSA rises above 10, the risk of prostate cancer is more than 50 percent, according to the American Cancer Society (ACS). If the doctor performs a digital rectal exam and finds the prostate to be hard or bumpy, that might also warrant a biopsy.

Biopsy Prep

Your physician will provide you with directions to prepare for the biopsy. Be sure your doctor is aware of all medications you are currently taking, including prescription and over-the-counter drugs. You may be instructed to stop some or all medications prior to the procedure and take prophylactic antibiotics. Also, ask your physician if she or he will use a numbing agent during the procedure.

Biopsy Procedure

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, according to the ACS. Precautionary antibiotics may be prescribed to reduce the risk of infection.

What to Expect During Recovery

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 physician if you experience difficulty or pain while urinating, heavy or ongoing bleeding, increasing pain, swelling, fever, or penile discharge.

What Happens Next?

A pathologist will examine the prostate samples collected during the biopsy; this lab work may take a few days to complete. If cancer is detected, the pathologist will detail the grade and structure of the cancer, and your medical team will help you identify 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. Your doctor will look at your overall health, family health history, physical exams, and the ongoing fluctuation of your PSA levels to determine whether or not more testing is needed.

Ultimately, be sure to touch base with your doctor regularly as you age, especially if you experience any problems with urination. While prostate cancer is a serious condition, there is a good chance it can be treated if detected early. In fact, according to the ACS, nearly 3 million men who have been diagnosed with prostate cancer are still living today. Maintaining a great relationship with your doctor is always helpful, so make sure you're being seen regularly.