Our Summary

This research paper explores the effectiveness of two different methods of performing biopsies for prostate cancer detection. The two methods are the sextant (which uses 6 samples) and the extended 12-core (which uses 12 samples). The study evaluated 550 patients who had undergone biopsies targeting lesions with a specific score (3-5) on the Prostate Imaging Reporting and Data System (PI-RADS).

It was found that systematic biopsies were necessary in patients who were over 65 years old, had a particular PI-RADS score, and had a certain number of systematic biopsy cores. For patients with a PI-RADS score of 4, the 12-core biopsy was needed.

However, the study concludes that in patients with a PI-RADS score of 3 or 5, the sextant biopsy should be recommended over the 12-core biopsy when an effective targeted biopsy is performed. This means that fewer samples might be sufficient if the biopsy is targeted effectively.

FAQs

  1. What are the two different methods of performing biopsies for prostate cancer detection discussed in the research paper?
  2. In what circumstances does the research suggest that the 12-core biopsy is necessary?
  3. What does the study recommend for patients with a PI-RADS score of 3 or 5 when an effective targeted biopsy is performed?

Doctor’s Tip

Overall, the doctor might advise the patient that the number of biopsy samples needed may vary depending on their age, PI-RADS score, and the effectiveness of the targeted biopsy. It is important to discuss with your doctor which method is most suitable for your specific case to ensure accurate results and minimize discomfort.

Suitable For

Typically, patients who are recommended for a prostate biopsy are those who have abnormal results on a prostate-specific antigen (PSA) test, digital rectal examination (DRE), or imaging tests such as MRI. Additionally, patients with a family history of prostate cancer, African American men, and those with certain genetic mutations may also be recommended for a prostate biopsy. Ultimately, the decision to recommend a prostate biopsy is made on a case-by-case basis by a healthcare provider based on a patient’s individual risk factors and symptoms.

Timeline

Before a prostate biopsy:

  1. Patient undergoes a digital rectal exam (DRE) to check for abnormalities in the prostate gland.
  2. Patient may undergo a prostate-specific antigen (PSA) blood test to measure levels of a protein produced by the prostate gland.
  3. Patient may undergo imaging tests such as a transrectal ultrasound (TRUS) or MRI to identify suspicious areas in the prostate.
  4. Patient may receive antibiotics to reduce the risk of infection during the biopsy procedure.

During the prostate biopsy:

  1. Patient is positioned on their side with knees drawn up towards the chest.
  2. Local anesthesia is applied to numb the area around the prostate.
  3. A thin needle is inserted through the rectum or perineum to remove small tissue samples from the prostate gland.
  4. The biopsy samples are sent to a lab for analysis to determine if cancer cells are present.

After the prostate biopsy:

  1. Patient may experience mild discomfort, bleeding, or blood in the urine or semen for a few days after the procedure.
  2. Patient may be advised to avoid heavy lifting or strenuous activity for a few days.
  3. Patient may receive the biopsy results within a week or two and discuss further treatment options with their healthcare provider.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a prostate biopsy?
  2. How will the biopsy results impact my treatment plan?
  3. What is the difference between a sextant biopsy and an extended 12-core biopsy, and which method do you recommend for me?
  4. How accurate are the biopsy results in detecting prostate cancer?
  5. Are there any alternative diagnostic tests or procedures that could provide more information about my condition?
  6. How long will it take to receive the biopsy results?
  7. Will I need to undergo any additional tests or procedures after the biopsy?
  8. What are the chances of experiencing pain or discomfort during or after the biopsy?
  9. How often should I have follow-up screenings or biopsies after this initial procedure?
  10. Are there any lifestyle changes or precautions I should take before or after the biopsy procedure?

Reference

Authors: Chung JH, Song W, Kang M, Sung HH, Jeon HG, Jeong BC, Seo SI, Jeon SS, Lee HM, Park BK. Journal: J Korean Med Sci. 2024 Feb 26;39(7):e63. doi: 10.3346/jkms.2024.39.e63. PMID: 38412610