Our Summary

This research paper discusses a study investigating the effectiveness of two different types of prostate cancer biopsies: targeted biopsy (TBx) and systematic biopsy (SBx). The researchers wanted to find out whether combining TBx and SBx can increase the rate of detecting prostate cancer and whether it would match the results from multiparametric magnetic resonance imaging (mpMRI), a type of imaging scan that helps identify cancerous areas in the prostate gland.

The study analyzed data from 1992 patients who had undergone an elastic fusion biopsy, a procedure that combines TBx and SBx, between 2011 and 2020. They found that the combined TBx and SBx detected prostate cancer in 63% of all cases and clinically significant prostate cancer in 38.8% of cases. Adding SBx to TBx increased the cancer detection rate by 4.5% for all cancers and 3.4% for clinically significant prostate cancer.

The study also found that prostate-specific antigen (PSA) density, a measure of prostate gland size and PSA level in the blood, was a strong predictor of cancer detection. The higher the PSA density, the higher the risk of prostate cancer.

In conclusion, combining TBx and SBx can detect a high number of prostate cancer cases that might otherwise be missed by mpMRI alone, thereby increasing the accuracy of prostate cancer diagnosis.

FAQs

  1. What are the two types of prostate cancer biopsies discussed in the study?
  2. How does the combination of targeted biopsy (TBx) and systematic biopsy (SBx) affect the detection rate of prostate cancer?
  3. What is the role of prostate-specific antigen (PSA) density in predicting prostate cancer?

Doctor’s Tip

A doctor might advise a patient undergoing a prostate biopsy to discuss the option of having both targeted and systematic biopsies done in order to increase the likelihood of detecting prostate cancer. Additionally, they may recommend monitoring PSA density as it can be a useful indicator of prostate cancer risk.

Suitable For

Patients who are typically recommended for a prostate biopsy include those with elevated PSA levels, abnormal digital rectal examination findings, or suspicious results from imaging tests such as mpMRI. Additionally, patients with a family history of prostate cancer or other risk factors may also be recommended for a biopsy to rule out or confirm the presence of cancer. The results of this study suggest that combining TBx and SBx can increase the detection rate of prostate cancer, particularly in patients with higher PSA density, leading to more accurate diagnosis and appropriate treatment planning.

Timeline

Before the prostate biopsy:

  • Patient undergoes a digital rectal exam (DRE) to check for any abnormalities in the prostate gland
  • Patient may have a blood test to measure prostate-specific antigen (PSA) levels
  • Patient may have a multiparametric magnetic resonance imaging (mpMRI) scan to identify suspicious areas in the prostate gland

After the prostate biopsy:

  • Patient may experience mild discomfort or pain in the prostate area
  • Patient may have some blood in their urine or semen for a few days after the biopsy
  • Patient may be advised to avoid strenuous activities for a few days
  • Patient may have to wait for the biopsy results to determine if they have prostate cancer and if treatment is needed.

What to Ask Your Doctor

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

  1. What is the purpose of the biopsy and why is it necessary?
  2. What are the potential risks and complications associated with the biopsy procedure?
  3. How will the biopsy results be used to determine my diagnosis and treatment plan?
  4. What is the difference between a targeted biopsy (TBx) and a systematic biopsy (SBx)?
  5. Will I need to undergo any additional tests or procedures before or after the biopsy?
  6. How accurate are the results of the biopsy in detecting prostate cancer?
  7. How long will it take to receive the biopsy results?
  8. What are the potential treatment options if prostate cancer is detected?
  9. Are there any lifestyle changes or precautions I should take before or after the biopsy?
  10. Are there any specific instructions I need to follow to prepare for the biopsy procedure?

Reference

Authors: Oderda M, Albisinni S, Benamran D, Calleris G, Ciccariello M, Dematteis A, Diamand R, Descotes JL, Fiard G, Forte V, Giacobbe A, Marquis A, Marra G, Messas A, Muto G, Peltier A, Rius L, Simone G, Roumeguere T, Faletti R, Gontero P. Journal: Prostate. 2023 Feb;83(2):162-168. doi: 10.1002/pros.24449. Epub 2022 Oct 19. PMID: 36259316