Our Summary

This study aims to reduce unnecessary prostate biopsies by creating a prediction model to identify significant prostate cancer (csPCa). The researchers analyzed data from 1632 men who had undergone prostate biopsies at Mount Sinai Hospital in New York and validated their model with data from 622 men at the University of Miami.

They found that a high PSA density (a measurement of prostate-specific antigen levels), a prior negative biopsy, and certain scores on the Prostate Imaging and Reporting Data System could predict csPCa. The prediction model was able to accurately match the actual rates of csPCa in the validation group.

The results of this study suggest that using this prediction model could avoid 35% of biopsies and 46% of diagnoses of low-risk prostate cancer, while missing only 5% of csPCa cases. Therefore, this model could be used to reduce the number of unnecessary prostate biopsies, which often lead to infections, without significantly impacting the detection of serious cases of prostate cancer.

FAQs

  1. What is the aim of this study on prostate biopsies?
  2. How accurate is the prediction model created by the researchers in identifying significant prostate cancer (csPCa)?
  3. What could be the potential benefits of using this prediction model in terms of reducing unnecessary prostate biopsies and diagnoses of low-risk prostate cancer?

Doctor’s Tip

One helpful tip a doctor might tell a patient about a prostate biopsy is to discuss the potential risks and benefits of the procedure beforehand. This includes the possibility of infection, bleeding, and discomfort during the biopsy, as well as the chance of detecting prostate cancer at an early stage. It’s important for patients to understand the reasons for recommending a biopsy and to ask any questions they may have about the procedure. Additionally, patients should follow any pre-biopsy instructions given by their healthcare provider to ensure the best possible outcome.

Suitable For

Patients who are typically recommended for prostate biopsy include those with elevated PSA levels, abnormal digital rectal exam findings, a family history of prostate cancer, or other risk factors for the disease. Additionally, patients with prior negative biopsies and certain imaging findings that suggest the presence of significant prostate cancer may also be recommended for biopsy. This study suggests that a prediction model incorporating factors such as PSA density, prior biopsy results, and imaging scores could help identify patients who are at higher risk for significant prostate cancer and may benefit from a biopsy.

Timeline

Before the prostate biopsy:

  1. Patient may experience symptoms such as difficulty urinating, frequent urination, blood in urine or semen, or pain in the lower back, hips, or pelvis.
  2. Patient’s doctor may recommend a prostate-specific antigen (PSA) blood test to check for elevated levels, which could indicate prostate cancer.
  3. Patient may undergo a digital rectal exam to check for any abnormalities in the prostate.
  4. Patient may be advised to stop taking certain medications, such as blood thinners, before the biopsy.

After the prostate biopsy:

  1. Patient may experience some discomfort or pain in the rectal area or during urination for a few days after the procedure.
  2. Patient may notice blood in urine, semen, or stools for a few days after the biopsy.
  3. Patient may be advised to avoid strenuous activities or heavy lifting for a few days to allow the biopsy site to heal.
  4. Patient will need to follow up with their doctor to discuss the biopsy results and determine next steps for treatment or monitoring.

What to Ask Your Doctor

  1. What is the purpose of a prostate biopsy and why is it being recommended for me?
  2. What are the potential risks and complications associated with a prostate biopsy?
  3. How accurate is the prediction model for identifying significant prostate cancer in my case?
  4. How will the results of the biopsy impact my treatment options?
  5. Are there any alternative tests or procedures that could provide similar information without the need for a biopsy?
  6. How should I prepare for the biopsy procedure?
  7. What can I expect during and after the biopsy procedure in terms of pain, recovery, and follow-up care?
  8. How soon will I receive the results of the biopsy and how will they be communicated to me?
  9. Are there any lifestyle changes or precautions I should take after the biopsy?
  10. What are the next steps if the biopsy results indicate the presence of prostate cancer?

Reference

Authors: Wagaskar VG, Lantz A, Sobotka S, Ratnani P, Parekh S, Falagario UG, Li L, Lewis S, Haines Iii K, Punnen S, Wiklund P, Tewari A. Journal: Urol J. 2022 Nov 8;19(5):379-385. doi: 10.22037/uj.v18i.6852. PMID: 34978065