Is The Prostate Cancer Biopsy An Effective Diagnostic Tool?

Despite the fact that there are various tests which may be undertaken when you suspect the possible presence of prostate cancer, the one sure way to detect the condition is through a prostate biopsy. But precisely how effective is the biopsy at detecting this particular condition?

In the US alone annually there are about 1,000,000 prostate biopsy procedures undertaken of which some 25 percent indicate the existence of prostate cancer. Of the other 75 percent of prostate biopsies however some 33 percent show false negative results. This means that approximately a quarter of those men being given a prostate biopsy are being cleared by their biopsy, in spite of the fact that they are suffering from prostate cancer.

On the surface therefore it could appear that the prostate biopsy is not a very effective test but these results do not in fact mean that there is anything wrong with the biopsy as a means of diagnosing the presence of prostate cancer. What it does mean however is the need to spot those individuals who, in spite of returning negative results, are nonetheless at considerable risk from prostate cancer and should therefore be given a follow-up biopsy.

The difficulty is that until very recently there has not been an easy way of determining those patients who are at risk. Fortunately, a study of more than 500 patients being investigated for the possible presence of prostate cancer could now provide an answer.

All of the men taking part in the study had previously had a negative prostate biopsy result but researchers discovered that when they studied the patient's prostate specific antigen test results and adjusted these for the size of the prostate gland they could identify those individuals who were likely to show a positive result on a follow-up biopsy.

In addition, the researchers found that patients who had a Gleeson score of 7 or above were at an increased risk from life-threatening prostate cancer and were once again more likely to receive a positive result from a further biopsy. The Gleeson score runs on a scale between 2 and 10 and a patient's score is calculated from a microscopic investigation of prostate biopsy tissue. Low scores show cancer with a relatively low risk of spread and a high score shows cancer which is far more likely to spread.

There are various prostate biopsy procedures in use now but perhaps the most frequently performed procedure is known as the core needle biopsy. In this case several very small samples of tissue are removed from different areas of the prostrate gland using a biopsy gun which fires a needle into the chosen area to remove the sample in just a fraction of a second. The samples collected are then sent off for laboratory analysis to find out whether cancer is present and, if so, to determine precisely how much of the prostate gland is affected.

A prostate biopsy is not a cheap procedure and is a test which can be quite upsetting for the patient. It is sometimes also a fairly painful procedure which may be accompanied by bleeding and the risk of infection. For these reasons it is in everyone's interest to spot those patients for whom a second biopsy is wise and to reduce as far as we can the number of needless follow-up biopsies being undertaken each year.

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