Our Summary

This research paper is about prostatic adenocarcinoma, which is the most common cancer found in men. Diagnosis of this cancer is usually made through a procedure known as a fine needle biopsy. The treatment options for patients may vary from monitoring the condition to more aggressive approaches like radical prostatectomy (surgical removal of the prostate) or radiation therapy. These decisions primarily depend on the findings from the biopsy.

The paper reviews key aspects such as the Gleason score and grade, which are used to assess the aggressiveness of the cancer, and the amount of tumor present. It also considers other factors like the spread of the cancer outside the prostate, invasion of the seminal vesicle (a pair of glands that help produce semen), invasion of the nerves, and invasion of the lymph and blood vessels. The status of the surgical margin (whether cancer cells are present at the outer edge of the tissue that was removed) and the lymph node (whether the cancer has spread to these parts of the immune system) are also discussed.

The aim of the study was to outline the most recent international guidelines for reporting on prostatic adenocarcinoma. This helps ensure that the findings from biopsies and radical prostatectomies are reported in a way that is consistent and useful for determining the best course of treatment.

FAQs

  1. What is the most common cancer affecting men?
  2. How is the diagnosis of prostatic adenocarcinoma commonly made?
  3. What parameters are considered in the treatment decision of prostatic adenocarcinoma?

Doctor’s Tip

A helpful tip a doctor might tell a patient about prostate biopsy is to make sure to follow any pre-biopsy instructions given by the healthcare provider, such as fasting before the procedure or stopping certain medications. It is also important to discuss any concerns or questions with the healthcare provider before the biopsy to ensure a better understanding of the procedure and potential outcomes. After the biopsy, it is important to follow up with the healthcare provider for the results and discuss any further steps or treatment options.

Suitable For

Patients who are typically recommended for a prostate biopsy include those with abnormal results from routine screening tests such as prostate-specific antigen (PSA) levels, digital rectal examination (DRE), or imaging studies. Additionally, patients with symptoms such as frequent urination, blood in the urine or semen, or pelvic pain may also be recommended for a prostate biopsy to rule out prostate cancer. Other factors that may lead to a recommendation for a prostate biopsy include a family history of prostate cancer, African American ethnicity, or a previous history of precancerous lesions in the prostate. Ultimately, the decision to perform a prostate biopsy is based on a combination of clinical factors and the individual patient’s risk profile.

Timeline

Before a prostate biopsy, a patient may experience symptoms such as frequent urination, difficulty urinating, blood in urine or semen, or pain in the back, hips, or pelvis. They may undergo blood tests, a digital rectal exam, and imaging tests such as a transrectal ultrasound or MRI to assess the prostate.

During the biopsy procedure, the patient will be positioned on their side with their knees drawn up to their chest. A local anesthetic will be injected into the prostate area, and a thin needle will be inserted to collect small samples of tissue from the prostate gland. The procedure may cause some discomfort or pain, but it is generally well-tolerated.

After the biopsy, the patient may experience side effects such as blood in the urine, semen, or stool, pain or discomfort in the rectal area, or difficulty urinating. These symptoms typically resolve within a few days. The biopsy samples will be sent to a pathologist for analysis, and the patient will receive the results from their healthcare provider.

Based on the pathology report, the patient and their healthcare provider will discuss treatment options, which may include active surveillance, surgery, radiation therapy, or other treatments. The Gleason score, tumor grade, and other important morphologic parameters in the biopsy specimen will help guide the treatment decision-making process. Regular follow-up appointments and monitoring will be scheduled to track the progression of the disease and assess the effectiveness of treatment.

What to Ask Your Doctor

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

  1. What are the reasons for recommending a prostate biopsy?
  2. What are the potential risks and complications associated with the biopsy procedure?
  3. How is the biopsy performed and what can I expect during and after the procedure?
  4. How long will it take to receive the biopsy results?
  5. What do different biopsy results, such as Gleason score, grade group, and tumor quantification, mean for my treatment options?
  6. How accurate are the biopsy results in determining the presence and aggressiveness of prostate cancer?
  7. Will I need additional tests or scans after the biopsy?
  8. What are the possible treatment options if the biopsy results show prostate cancer?
  9. Are there any lifestyle changes or precautions I should take after the biopsy?
  10. How frequently should I have follow-up appointments to monitor my prostate health after the biopsy?

Reference

Authors: Tóth E, Salamon F. Journal: Magy Onkol. 2019 Mar 19;63(1):10-15. Epub 2019 Jan 15. PMID: 30889616