Our Summary

This research paper studies the relationship between the size of different areas in the prostate, chronic inflammation, and the risk of prostate cancer. The researchers looked at patients who had no signs of prostate cancer during a standard physical exam and whose levels of a particular protein (PSA) associated with prostate cancer were low. They then took samples from the patients’ prostates to check for cancer and chronic inflammation.

The results showed that patients with a higher ratio of the size of the central part of the prostate to the outer part (PVI) and chronic inflammation (PCI) were less likely to have prostate cancer. This means that the size of different areas of the prostate and the presence of chronic inflammation could help doctors predict a patient’s risk of prostate cancer, even when other signs and tests are normal.

FAQs

  1. What is the relationship between the size of different areas in the prostate and prostate cancer risk?
  2. How does chronic inflammation affect the risk of prostate cancer?
  3. Can the presence of chronic inflammation and the size of different areas of the prostate predict a patient’s risk of prostate cancer even when other tests are normal?

Doctor’s Tip

One helpful tip a doctor might tell a patient about prostate biopsy is to discuss the potential risks and benefits of the procedure. It is important for the patient to understand that while a biopsy can help diagnose prostate cancer, there is a small risk of complications such as infection, bleeding, or pain. The doctor may also recommend discussing any concerns or questions about the biopsy with them before proceeding with the procedure. Additionally, the doctor may suggest following any specific instructions, such as avoiding blood-thinning medications before the biopsy, to ensure a successful and safe procedure.

Suitable For

Based on these findings, patients who are typically recommended for a prostate biopsy may include those with:

  1. Elevated levels of PSA: Patients with high levels of PSA in their blood are at an increased risk of prostate cancer and may be recommended for a biopsy to confirm or rule out the presence of cancer.

  2. Abnormal digital rectal exam (DRE) findings: Patients with abnormal findings during a digital rectal exam, such as a hard or lumpy prostate, may be recommended for a biopsy to further investigate the possibility of prostate cancer.

  3. Family history of prostate cancer: Patients with a family history of prostate cancer, especially in first-degree relatives, may be recommended for a biopsy as they are at an increased risk of developing the disease.

  4. Previous negative biopsy results: Patients who have had previous negative biopsy results but continue to have concerning symptoms or elevated PSA levels may be recommended for a repeat biopsy to ensure that cancer is not overlooked.

  5. Suspicious imaging findings: Patients with suspicious findings on imaging tests, such as MRI or ultrasound, may be recommended for a biopsy to confirm the presence of cancer.

Overall, the decision to recommend a prostate biopsy is typically based on a combination of factors, including PSA levels, DRE findings, family history, imaging results, and other risk factors. It is important for patients to discuss their individual risk factors with their healthcare provider to determine if a biopsy is necessary for further evaluation.

Timeline

Before the prostate biopsy:

  • Patient may have a standard physical exam that shows no signs of prostate cancer
  • PSA levels are checked and found to be low
  • Patient may undergo imaging tests such as a MRI or ultrasound to determine if there are any abnormalities in the prostate
  • Doctor recommends a prostate biopsy to further investigate the presence of cancer

After the prostate biopsy:

  • Patient undergoes a transrectal ultrasound-guided biopsy, where samples are taken from the prostate
  • Patient may experience discomfort, bleeding, or infection at the biopsy site
  • Biopsy samples are sent to a pathology lab for analysis
  • Results show whether the patient has prostate cancer, and if so, the stage and grade of the cancer
  • Doctor discusses treatment options with the patient, which may include active surveillance, surgery, radiation therapy, or hormone therapy.

What to Ask Your Doctor

  1. What are the potential risks and side effects of a prostate biopsy?

  2. How accurate is a prostate biopsy in detecting prostate cancer?

  3. How will the results of the biopsy impact my treatment plan?

  4. Are there any alternative tests or procedures that can be done instead of a prostate biopsy?

  5. How long will it take to get the results of the biopsy?

  6. Will I need to do anything to prepare for the biopsy?

  7. How many samples will be taken during the biopsy procedure?

  8. Will I need to take any medications before or after the biopsy?

  9. How often should I have a prostate biopsy done, especially if I have a history of chronic inflammation in the prostate?

  10. Are there any lifestyle changes or preventative measures I can take to reduce my risk of prostate cancer, especially if I have a higher PVI and PCI ratio?

Reference

Authors: Porcaro AB, Tafuri A, Sebben M, Novella G, Processali T, Pirozzi M, Amigoni N, Rizzetto R, Shakir A, Panunzio A, De Michele M, Brunelli M, Cerruto MA, Migliorini F, Siracusano S, Artibani W. Journal: Urol Int. 2019;103(4):415-422. doi: 10.1159/000502659. Epub 2019 Aug 29. PMID: 31466070