Though there are several different tests that may be performed when the presence of prostate cancer is suspected, the only sure way to detect the condition is the prostate biopsy. But just how effective is the biopsy at detecting this particular disease?
In the US alone every year there are approximately one million prostate biopsies performed of which some 25 percent indicate the existence of prostate cancer. However, of the remaining 75 percent of prostate biopsies about one-third also produce false negative results. This means that approximately a quarter of all men having a prostate biopsy are being cleared by their biopsy, notwithstanding the fact that they actually have prostate cancer.
On the face of it therefore it could appear that the prostate biopsy is not a very satisfactory test but the results do not demonstrate that there is anything wrong with the prostate biopsy procedure as a means of confirming the presence of prostate cancer. What it does show however is that there is a need to spot those individuals who, despite returning a negative result, are nonetheless at high risk from prostate cancer and should therefore undergo a follow-up biopsy.
The difficulty is that until very recently there has been no easy method of determining patients who are at risk. Luckily, a study of more than five hundred individuals being investigated for the presence of prostate cancer could now provide an answer.
All of the patients investigated in the study had already received a negative prostate biopsy result but the researchers discovered that when they studied the patient's prostate specific antigen (PSA) test results and these were adjusted for the size of the prostate they could identify those individuals who were likely to return positive results on a second biopsy.
In addition, the researchers found that men who had a Gleeson score of 7 or more were at greater risk from life-threatening prostate cancer and were again more likely to produce a positive result on a second biopsy. The Gleeson score runs on a scale between 2 and 10 and the score is calculated from a microscopic investigation of the prostate biopsy tissue. Low scores show cancer with a relatively low risk of spread and a high score points to cancer which is much more likely to spread.
There are several different prostate biopsy procedures available now although perhaps the most often performed procedure is the core needle biopsy. In this case several tiny samples of tissue are taken from different parts of the prostrate using a biopsy gun which fires a needle into the chosen area and removes the sample within just a fraction of a second. These samples are then sent for laboratory examination to establish whether or not cancer is present and, if it is, to establish just how much of the prostate is affected.
A prostate biopsy is not a cheap procedure and is one which can also be relatively worrying for the subject. It is sometimes also a fairly painful procedure which may involve bleeding and the risk of infection. As a consequence it is important to spot those individuals for whom a second biopsy is sensible and to reduce as far as possible the number of needless follow-up biopsies being undertaken every year.
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