Our Summary

This research paper investigates the best method to diagnose prostate cancer. The study looked at 120 patients who underwent two types of biopsies - a randomized biopsy (BR) and a targeted biopsy (BC).

The patients were divided into three groups, receiving 6, 12 or 18 randomized biopsies. In addition, they were also given a targeted biopsy. The study aimed to compare the effectiveness of these different biopsy combinations and numbers in detecting prostate cancer.

The results showed that the detection rate for cancer was 61% with 6 biopsies, 82% with 12, and 91% with 18. When a targeted biopsy was added, the detection rate increased by 27% for those with 6 biopsies, 13% for those with 12 and 9% for those with 18. The targeted biopsy found 70% of all prostate cancers. Nine percent of the cancers were missed when only a randomized biopsy was used.

The study concluded that adding a targeted biopsy to the randomized biopsy increased the detection of prostate cancer by 10%. Also, the optimal combination for detecting prostate cancer was found to be 12 randomized biopsies plus a targeted biopsy, as this method found 95% of all prostate cancers and 97% of significant cancers.

FAQs

  1. What was the aim of the research paper on prostate cancer diagnosis?
  2. What were the detection rates for prostate cancer with different numbers of randomized biopsies?
  3. What was the conclusion of the study regarding the best method to diagnose prostate cancer?

Doctor’s Tip

A helpful tip a doctor might tell a patient about prostate biopsy is that adding a targeted biopsy to a randomized biopsy can significantly increase the detection rate of prostate cancer. The optimal combination for detecting prostate cancer is 12 randomized biopsies plus a targeted biopsy, as this method found 95% of all prostate cancers and 97% of significant cancers. It is important to discuss with your doctor the best biopsy combination for your individual case to ensure the most accurate diagnosis possible.

Suitable For

Patients who are typically recommended for a prostate biopsy include:

  1. Patients with elevated levels of prostate-specific antigen (PSA) in their blood, which may indicate the presence of prostate cancer.
  2. Patients with abnormal digital rectal examination (DRE) results, such as a hard or lumpy prostate gland.
  3. Patients with a family history of prostate cancer, especially in first-degree relatives.
  4. Patients with a previous negative biopsy but persistent or increasing PSA levels.
  5. Patients with symptoms suggestive of prostate cancer, such as frequent urination, difficulty urinating, or blood in the urine.
  6. Patients with a suspected or confirmed prostate nodule on imaging studies, such as ultrasound or MRI.
  7. Patients with other risk factors for prostate cancer, such as older age or African American ethnicity.

Overall, the decision to recommend a prostate biopsy is made on a case-by-case basis, taking into account the patient’s individual risk factors, symptoms, and test results. The results of this study suggest that a combination of randomized and targeted biopsies may be the most effective method for detecting prostate cancer in patients who are recommended for a biopsy.

Timeline

Before the prostate biopsy:

  • Patient may experience symptoms such as frequent urination, difficulty urinating, blood in urine or semen, or pain in the back, hips, or pelvis.
  • Patient may undergo a digital rectal exam (DRE) to check for any abnormalities in the prostate.
  • Patient may have blood tests done to check for prostate-specific antigen (PSA) levels, which can indicate the presence of prostate cancer.
  • Patient may have imaging tests such as a transrectal ultrasound or MRI to help guide the biopsy procedure.

After the prostate biopsy:

  • Patient may experience some discomfort or pain in the prostate area, as well as some blood in the urine, semen, or stool.
  • Patient may be prescribed antibiotics to prevent infection.
  • Patient may need to avoid strenuous activity for a few days after the procedure.
  • Patient may need to follow up with their doctor to discuss the biopsy results and determine the next steps for treatment.

What to Ask Your Doctor

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

  1. What is the purpose of the biopsy and why is it recommended for me?
  2. What are the risks and potential complications associated with the biopsy procedure?
  3. How many biopsies will be taken and what type of biopsy will be performed (randomized or targeted)?
  4. What is the accuracy rate of the biopsy in detecting prostate cancer?
  5. Will I need to undergo any special preparation before the biopsy procedure?
  6. How long will it take to receive the biopsy results?
  7. What follow-up care or treatment options may be recommended based on the biopsy results?
  8. Are there any alternative diagnostic tests or procedures that can be considered instead of a biopsy?
  9. What factors should I consider when deciding on the number of biopsies to undergo?
  10. Are there any lifestyle or dietary changes I should make before or after the biopsy to improve the accuracy of the results?

Reference

Authors: Defontaines J, Salomon L, Champy C, Cholley I, Chiaradia M, de la Taille A. Journal: Prog Urol. 2017 Dec;27(16):1023-1030. doi: 10.1016/j.purol.2017.09.002. Epub 2017 Nov 6. PMID: 29122487