Our Summary

This research paper compares two methods of detecting prostate cancer: magnetic resonance imaging-targeted biopsy (MRI-TB) and standard systematic biopsy (SB). After reviewing several studies, the authors found that MRI-TB is better at detecting serious prostate cancer than SB. However, since some significant cancers were only found through SB, they suggest a combination of both methods to avoid missing any serious cases.

FAQs

  1. What are the two methods of detecting prostate cancer mentioned in this research?
  2. Which method is found to be better at detecting serious prostate cancer?
  3. Why do the authors suggest a combination of both MRI-TB and SB methods?

Doctor’s Tip

One helpful tip a doctor might tell a patient about prostate biopsy is to discuss the option of a combination approach using both MRI-targeted biopsy and standard systematic biopsy. This can help increase the chances of detecting any serious cases of prostate cancer that may be missed by using only one method. It’s important to have an open conversation with your doctor about all available options and the potential benefits and risks of each approach.

Suitable For

Patients who are typically recommended for a prostate biopsy are those who have abnormal results on a prostate-specific antigen (PSA) test, as well as those who have abnormal findings on a digital rectal exam (DRE). Additionally, patients with a family history of prostate cancer or certain genetic mutations may also be recommended for a prostate biopsy. Ultimately, the decision to undergo a prostate biopsy should be made in consultation with a healthcare provider who can assess the individual’s risk factors and determine the most appropriate course of action.

Timeline

Before prostate biopsy:

  1. Patient consults with a urologist and discusses symptoms, family history, and risk factors for prostate cancer.
  2. Patient may undergo a digital rectal exam (DRE) to feel for abnormalities in the prostate gland.
  3. Patient may undergo a prostate-specific antigen (PSA) blood test to measure levels of a protein produced by the prostate gland.
  4. If PSA levels are elevated or abnormalities are found during the DRE, the patient may be recommended for a prostate biopsy.
  5. Patient may undergo a pre-biopsy MRI scan to identify suspicious areas in the prostate gland.

During prostate biopsy:

  1. Patient receives local anesthesia to numb the area before the biopsy procedure.
  2. Urologist uses ultrasound guidance to target specific areas in the prostate gland for biopsy.
  3. Urologist may perform a combination of MRI-TB and SB biopsies to ensure comprehensive sampling.
  4. Patient may experience discomfort or pain during the biopsy procedure.

After prostate biopsy:

  1. Patient may experience temporary side effects such as blood in urine or semen, pain or discomfort in the rectum or perineum, or urinary symptoms.
  2. Biopsy samples are sent to a lab for analysis to determine if cancer cells are present.
  3. Patient receives follow-up consultation with the urologist to discuss biopsy results and determine next steps for treatment or monitoring.
  4. If cancer is detected, patient may undergo further tests and procedures to determine the stage and aggressiveness of the cancer.

What to Ask Your Doctor

  1. Can you explain the differences between MRI-targeted biopsy and standard systematic biopsy?
  2. What are the potential risks and side effects associated with prostate biopsy?
  3. How accurate are the results of each type of biopsy in detecting prostate cancer?
  4. Are there any specific factors that may make one type of biopsy more suitable for me than the other?
  5. How will the results of the biopsy impact my treatment options and prognosis?
  6. Are there any alternative tests or procedures that can provide additional information about my prostate health?
  7. How should I prepare for the biopsy procedure and what can I expect during and after the biopsy?
  8. Will I need to undergo additional biopsies or follow-up tests based on the results of the initial biopsy?
  9. What are the potential limitations or drawbacks of using a combination of MRI-TB and SB for detecting prostate cancer?
  10. Are there any specific guidelines or recommendations for monitoring my prostate health after the biopsy?

Reference

Authors: Yamada Y, Ukimura O, Kaneko M, Matsugasumi T, Fujihara A, Vourganti S, Marks L, Sidana A, Klotz L, Salomon G, de la Rosette J. Journal: World J Urol. 2021 Mar;39(3):677-686. doi: 10.1007/s00345-020-03366-x. Epub 2020 Jul 29. PMID: 32728885