Our Summary

This research paper is about a study that looked into different ways to identify significant prostate cancer (PCa) in patients. It particularly focused on patients who still had high levels of prostate-specific antigen (PSA), a protein produced by the prostate gland, in their blood after a negative prostate biopsy. A biopsy is a procedure where doctors take a small tissue sample from the body to examine it for disease.

The researchers used several methods to try to identify PCa. These included different types of PSA tests, a prostate health index (PHI), and magnetic resonance imaging (MRI) scans. The study found that the PHI and PHI density tests were the most accurate in predicting significant PCa.

In other words, the study found that even after a biopsy comes back negative, there’s still a chance that a patient could have significant PCa. Therefore, the researchers suggest that doctors could use the PHI and PHI density tests as additional tools to help detect PCa in these patients.

FAQs

  1. What methods did the researchers use to identify significant prostate cancer (PCa) in patients who had high PSA levels after a negative biopsy?
  2. Which tests were found to be the most accurate in predicting significant PCa, according to this study?
  3. What do the researchers suggest doctors do when a biopsy comes back negative but a patient still has high PSA levels?

Doctor’s Tip

As a doctor, I would advise my patient to discuss these additional testing options with their healthcare provider if they still have high levels of PSA after a negative biopsy. It’s important to stay proactive about monitoring your prostate health and catching any potential issues early on. Remember, early detection can greatly improve treatment outcomes for prostate cancer. Be sure to follow up with your doctor regularly and communicate any concerns or changes in your health.

Suitable For

Patients who are typically recommended for a prostate biopsy include those with elevated PSA levels, abnormal digital rectal exam findings, family history of prostate cancer, or other risk factors for the disease. Additionally, patients who have persistent high PSA levels after a negative biopsy may also be recommended for a repeat biopsy to further investigate the possibility of significant PCa.

Timeline

Before the prostate biopsy:

  • Patient may experience symptoms such as frequent urination, difficulty urinating, or blood in urine
  • Doctor may order a PSA blood test to check for elevated levels of PSA
  • If PSA levels are high, doctor may recommend a prostate biopsy
  • Patient may undergo further tests such as a digital rectal exam or MRI scan to assess the size and shape of the prostate

During the prostate biopsy:

  • Patient will be given anesthesia to numb the area
  • Doctor will insert a thin needle through the rectum or perineum to collect tissue samples from the prostate
  • Patient may experience discomfort or minor bleeding after the procedure

After the prostate biopsy:

  • Patient may have some blood in urine or semen for a few days
  • Doctor will send tissue samples to a lab for analysis
  • Results of the biopsy can take a few days to a week to come back
  • If biopsy is negative, patient may still have high PSA levels indicating potential PCa
  • Doctors may recommend further tests such as PHI or MRI to confirm or rule out significant PCa

Overall, the timeline of a patient’s experience before and after a prostate biopsy involves initial symptoms, diagnostic tests, the biopsy procedure itself, and follow-up tests to determine the presence of significant PCa.

What to Ask Your Doctor

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

  1. What are the risks and benefits of having a prostate biopsy?
  2. How will the biopsy be performed and what can I expect during the procedure?
  3. How long will it take to receive the results of the biopsy?
  4. What are the possible complications or side effects of a prostate biopsy?
  5. What will the biopsy results tell us about my prostate health?
  6. If the biopsy results come back negative, does that mean I definitely do not have prostate cancer?
  7. If my PSA levels are still high after a negative biopsy, what further tests or procedures should be considered?
  8. Are there any alternative methods to detect prostate cancer besides a biopsy?
  9. What are the benefits of using the prostate health index (PHI) or MRI scans in addition to a biopsy?
  10. How will the results of the PHI or MRI scans impact my treatment plan moving forward?

Reference

Authors: Wang Z, Chan MT, Tsang WC, Chiong E. Journal: World J Urol. 2022 Sep;40(9):2255-2260. doi: 10.1007/s00345-022-04085-1. Epub 2022 Jul 12. PMID: 35821266