Our Summary

This research paper discusses the 2024 guidelines for diagnosing prostate cancer, which recommend a new approach called a targeted and perilesional biopsy (TPLBx). This new method could be more effective than the traditional method of using a combined targeted and systematic biopsy. The new TPLBx method could help reduce the overdiagnosis of minor cancers and lessen the degree of change that can sometimes occur with the old biopsy method.

FAQs

  1. What is the recommended biopsy strategy for primary diagnosis of prostate cancer according to the 2024 EAU-EANM-ESTRO-ESUR-ISUP-SIOG guidelines?
  2. How does the targeted and perilesional biopsy (TPLBx) strategy differ from the classical approach of combined targeted and systematic biopsy?
  3. What are the potential benefits of using the TPLBx strategy for prostate cancer diagnosis?

Doctor’s Tip

One helpful tip a doctor might tell a patient about prostate biopsy is to discuss the benefits and risks of the procedure beforehand. It is important to understand that while a biopsy can help diagnose prostate cancer, there is a small risk of complications such as bleeding or infection. It is also important to follow any pre-biopsy instructions given by your doctor, such as avoiding blood-thinning medications or fasting before the procedure. Finally, make sure to discuss any concerns or questions you have with your doctor before the biopsy to ensure you are fully informed and prepared.

Suitable For

Patients who are typically recommended for prostate biopsy include:

  1. Patients with elevated levels of prostate-specific antigen (PSA) in their blood, which may indicate the presence of prostate cancer.
  2. Patients with abnormal findings on a digital rectal exam (DRE), such as a suspicious nodule or hard area on the prostate gland.
  3. Patients with a family history of prostate cancer, especially if they have a first-degree relative (father or brother) who was diagnosed with the disease at a young age.
  4. Patients with persistent symptoms such as frequent urination, difficulty starting or stopping urination, or blood in the urine.
  5. Patients with a previous negative biopsy but persistent clinical suspicion of prostate cancer.

It is important for patients to discuss their individual risk factors and symptoms with their healthcare provider to determine if a prostate biopsy is necessary.

Timeline

Before prostate biopsy:

  • Patient undergoes a digital rectal exam (DRE) to assess the size and shape of the prostate gland.
  • Patient may undergo imaging tests such as MRI or transrectal ultrasound to identify suspicious areas in the prostate.
  • Patient may receive antibiotics to prevent infection.
  • Patient may be instructed to stop taking certain medications or supplements that can increase bleeding risk.
  • Patient may receive information about the procedure and potential risks.

After prostate biopsy:

  • Patient may experience some discomfort, bleeding, or blood in urine or semen for a few days following the procedure.
  • Patient may need to take antibiotics to prevent infection.
  • Patient may receive the biopsy results within a week or two.
  • If cancer is detected, patient may undergo further tests to determine the stage and aggressiveness of the cancer.
  • Patient may discuss treatment options with their healthcare provider, which may include active surveillance, surgery, radiation therapy, or other treatments.

Overall, the process of undergoing a prostate biopsy involves preparation, the procedure itself, and follow-up care and decisions based on the results of the biopsy.

What to Ask Your Doctor

  1. Why do I need a prostate biopsy?
  2. What are the risks and benefits of a prostate biopsy?
  3. What is the difference between a targeted and systematic biopsy?
  4. How will the biopsy be performed?
  5. Will I need anesthesia for the procedure?
  6. How long will it take to get the results of the biopsy?
  7. What will happen if the biopsy results are positive for cancer?
  8. Are there any alternative tests or procedures that could be done instead of a biopsy?
  9. How often will I need to have a prostate biopsy if the results are negative?
  10. Are there any lifestyle changes I should make before or after the biopsy?

Reference

Authors: Rouvière O, van Leenders GJLH, Eberli D; EAU-EANM-ESTRO-ESUR-ISUP-SIOG Prostate Cancer Guidelines Panel. Journal: Eur Urol. 2024 Oct;86(4):295-296. doi: 10.1016/j.eururo.2024.07.001. Epub 2024 Jul 23. PMID: 39043548