Our Summary

This research studied two different types of biopsy methods used to detect prostate cancer: systematic sextant biopsy (S-Bx) and magnetic resonance imaging-targeted biopsy (T-Bx). The study looked at patients who had undergone one or both of these biopsy methods and then had their prostates removed between 2015 and 2019.

The researchers found that prostate cancer was detected in 14% of patients using S-Bx only, in 18% using T-Bx only, and in 68% using both methods. Interestingly, the cases where cancer was detected using T-Bx only or both methods were associated with higher tumor grades and larger estimated tumor volumes. However, there were no significant differences in tumor volume, tumor grade, or other clinical features when comparing cases detected by S-Bx only vs. T-Bx only or both methods.

The study also found that patients whose cancer was detected using T-Bx only or both methods had a higher risk of the cancer coming back after their prostates were removed compared to those detected by S-Bx only. However, there was no significant difference in the risk of recurrence between the T-Bx only and both methods groups.

Overall, the study suggests that detecting prostate cancer using T-Bx, either alone or in combination with S-Bx, might be linked to larger tumor sizes and worse prognoses. However, the researchers did not find that simultaneous detection using S-Bx had any significant impact on clinical outcomes in patients with prostate cancer detected by T-Bx.

FAQs

  1. What are the two types of biopsy methods studied for detecting prostate cancer?
  2. Does using both S-Bx and T-Bx biopsy methods yield higher detection rates of prostate cancer?
  3. Is there a difference in the risk of cancer recurrence between the S-Bx only method and the T-Bx only or both methods?

Doctor’s Tip

A doctor might advise a patient undergoing a prostate biopsy to discuss with their healthcare provider the different biopsy methods available, including systematic sextant biopsy and magnetic resonance imaging-targeted biopsy. It is important for the patient to understand the potential benefits and risks associated with each method in order to make an informed decision about their care. Additionally, the patient should follow up with their healthcare provider regularly to monitor their prostate health and discuss any concerns or changes in their condition.

Suitable For

Patients who are typically recommended for prostate biopsy include those with elevated prostate-specific antigen (PSA) levels, abnormal digital rectal exam (DRE) findings, or other symptoms suggestive of prostate cancer. Additionally, patients with a family history of prostate cancer or other risk factors may also be recommended for a biopsy.

It is important for patients to discuss the risks and benefits of prostate biopsy with their healthcare provider to determine the most appropriate course of action based on their individual circumstances.

Timeline

Before the prostate biopsy:

  1. Patient presents with symptoms such as urinary issues, elevated PSA levels, or abnormal digital rectal exam.
  2. Patient undergoes pre-biopsy evaluation, including PSA test, digital rectal exam, and possibly imaging studies like MRI or ultrasound.
  3. Patient discusses biopsy options with their healthcare provider and decides on the best approach.

During the prostate biopsy:

  1. Patient receives anesthesia or sedation to minimize discomfort.
  2. S-Bx: Six tissue samples are taken systematically from different areas of the prostate. T-Bx: MRI is used to identify suspicious areas in the prostate, and targeted biopsies are taken from those specific locations.
  3. The biopsy procedure takes about 20-30 minutes to complete.

After the prostate biopsy:

  1. Patient may experience some discomfort, blood in the urine or semen, or mild pain in the prostate area for a few days.
  2. Pathologist examines the biopsy samples to determine if cancer is present and assess the grade and stage of the tumor.
  3. Patient meets with their healthcare provider to discuss the biopsy results and determine the next steps for treatment or monitoring.
  4. Depending on the results, patient may undergo further testing, such as imaging studies or additional biopsies, to guide treatment decisions.

What to Ask Your Doctor

  1. What are the risks and benefits of undergoing a prostate biopsy?

  2. How accurate are the results of a prostate biopsy in detecting prostate cancer?

  3. What is the difference between systematic sextant biopsy and magnetic resonance imaging-targeted biopsy?

  4. Which biopsy method do you recommend for me based on my specific case?

  5. What is the likelihood of the cancer being missed by one biopsy method versus the other?

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

  7. What are the potential complications of a prostate biopsy?

  8. How long will it take to receive the results of the biopsy?

  9. Are there any alternatives to a prostate biopsy that I should consider?

  10. What should I expect during and after the biopsy procedure?

Reference

Authors: Suresh N, Teramoto Y, Wang Y, Miyamoto H. Journal: Urol Oncol. 2022 May;40(5):193.e7-193.e14. doi: 10.1016/j.urolonc.2022.02.010. Epub 2022 Apr 8. PMID: 35410776