Prostate biopsy

A prostate biopsy is a type of test. Your doctor takes about 10 to 12 small tissue samples from your prostate. Then another doctor looks at the tissue under a microscope to see if there are cancer cells.

You may need a prostate biopsy if your doctor found something of concern in your lab work or during your exam. A biopsy can help find out if you have prostate cancer. It may also be done for other reasons, such as monitoring the growth of prostate cancer for someone on active surveillance.

Some people have a prostate imaging test, such as an MRI or a CT scan, before their biopsy. The test results are used during the biopsy to select the areas of the prostate to sample.

Before your biopsy, you may be given antibiotics to prevent infection. You may be asked to take off all of your clothes and put on a hospital gown.

Through the rectum

• You may be asked to kneel, lie on your side, or lie on your back.
• Your doctor may inject an anesthetic around and into the prostate to numb the area before samples are taken.
• An ultrasound probe will be gently inserted into your rectum.
• A thin tool with a spring-loaded needle will be inserted next to the ultrasound probe. The ultrasound helps to locate the areas on the prostate where the samples will be taken. If you had an MRI or CT scan, the test results will also be used to guide the sampling.
• The needle enters the prostate and removes a sample. About 10 to 12 samples are usually taken.

Through the perineum

• You will lie on an exam table either on your side or on your back with your knees bent. You will get anesthesia. The anesthesia may make you sleep. Or it may just numb the area being worked on.
• Your doctor will make a small cut in your perineum. Then the doctor will collect samples from the prostate through the cut with a special tool.
• An ultrasound probe inserted into the rectum may be used to help find the locations in the prostate where samples need to be taken. Sometimes other imaging, such as MRI, is used instead of or along with ultrasound. Or the test results from other imaging, such as an MRI or a CT scan, may be used to guide the sampling.
• If you have a general anesthetic, you will be in a recovery room for a few hours after the biopsy.

If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.

Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.

Most prostate biopsies are done with local anesthesia. But if you are having general anesthesia, you will need to have someone to take you home, since anesthesia will make it unsafe for you to drive or get home on your own. Some pain medicines can also make it unsafe for you to drive.

Results are usually ready within several days.

Normal prostate biopsy results do not rule out cancer. There's a chance that a cancer may be missed since the biopsy takes a small amount of tissue.

If the test finds prostate cancer cells, your biopsy report will include a Gleason score and a Grade Group number. These numbers are ways of describing how the cancer cells look under a microscope and how likely those cells are to grow quickly and spread. Your doctor will discuss this with you.