Our Summary

This study was conducted to see if there were differences in detecting prostate cancer using three types of prostate biopsies: fusion prostate biopsy (FPB), cognitive biopsy (PCB), and systematic biopsy (SB). The study was done on 195 patients who were suspected to have prostate cancer at a hospital in Granada, Spain, in 2021.

The patients were split into three groups. Group 1 had the FPB procedure, Group 2 had the PCB procedure, and Group 3 had the SB procedure. The results showed that FPB and PCB detected more positive biopsies compared to SB, but the differences were not significant.

However, when they excluded certain types of scans (PI-RADS 3) from the analysis, they found that FPB was significantly better at detecting cancer compared to PCB and SB.

The study concludes that the presence of a PI-RADS 3 lesion in an MRI scan should not be the sole reason to recommend a prostate biopsy. However, for PI-RADS 4 and 5 lesions, FPB is recommended as it is superior to PCB and SB in these cases.

FAQs

  1. What were the three types of prostate biopsies studied in this research?
  2. Which type of prostate biopsy was found to be most effective at detecting cancer when certain types of scans were excluded from the analysis?
  3. What is the study’s conclusion regarding the presence of a PI-RADS 3 lesion in an MRI scan and the recommendation for a prostate biopsy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about prostate biopsy is to discuss the different types of biopsies available, such as fusion prostate biopsy (FPB), cognitive biopsy (PCB), and systematic biopsy (SB), and to consider opting for FPB if a PI-RADS 4 or 5 lesion is detected on an MRI scan. This type of biopsy has been shown to be more effective in detecting prostate cancer in these cases compared to PCB and SB. It is important to have a thorough discussion with your doctor about the best biopsy option for your specific situation.

Suitable For

Patients who are suspected to have prostate cancer, especially those with PI-RADS 4 and 5 lesions on MRI scans, are typically recommended to undergo a prostate biopsy. This includes patients with elevated PSA levels, abnormal digital rectal exams, or other concerning symptoms. Additionally, patients who have had previous negative biopsies but continue to have suspicious findings on imaging may also be recommended for a prostate biopsy.

Timeline

Before the prostate biopsy:

  1. Patient receives a referral from their primary care physician to see a urologist.
  2. Urologist reviews the patient’s medical history and conducts a physical exam.
  3. Patient undergoes a prostate-specific antigen (PSA) test and a digital rectal exam (DRE).
  4. If results indicate a high likelihood of prostate cancer, the urologist recommends a prostate biopsy.

During the prostate biopsy:

  1. Patient is informed about the procedure and any potential risks or side effects.
  2. Local anesthesia is administered to numb the area around the prostate.
  3. A thin, biopsy needle is inserted through the rectum or perineum to collect tissue samples from the prostate.
  4. The entire procedure typically takes about 15-20 minutes.

After the prostate biopsy:

  1. Patient may experience some discomfort, bleeding, or blood in the urine or semen for a few days.
  2. Results of the biopsy are typically available within a week.
  3. If cancer is detected, further tests may be needed to determine the stage and aggressiveness of the cancer.
  4. Treatment options, such as surgery, radiation therapy, or active surveillance, are discussed with the patient.

What to Ask Your Doctor

Some questions a patient should ask their doctor about prostate biopsy include:

  1. What are the risks and benefits of each type of prostate biopsy (FPB, PCB, SB)?
  2. How accurate is each type of biopsy in detecting prostate cancer?
  3. Which type of biopsy is recommended for my specific case based on my MRI results?
  4. Are there any alternative procedures or tests that can be considered instead of a biopsy?
  5. What can I expect during and after the biopsy procedure?
  6. How long will it take to get the results of the biopsy?
  7. What are the potential complications or side effects of a prostate biopsy?
  8. How will the biopsy results be used to determine the best course of treatment for me?
  9. Are there any lifestyle changes or precautions I should take before or after the biopsy?
  10. Are there any specific questions or concerns I should discuss with a specialist before proceeding with the biopsy?

Reference

Authors: Guerra-Lacambra M, Yañez-Castillo Y, Folgueral-Corral M, Melgarejo-Segura MT, Del Carmen Cano-García M, Sánchez-Tamayo FJ, Martín-Rodríguez JL, Arrabal-Polo MA, Arrabal-Martin M. Journal: J Cancer Res Clin Oncol. 2023 Nov;149(16):15085-15090. doi: 10.1007/s00432-023-05293-x. Epub 2023 Aug 24. PMID: 37615820