Prostate Cancer Diagnosis: The Prostate Biopsy

By Dr. Steve Pierpaoli & Dr. David Raminski

At Associated Urological Specialists, we often see patients who are concerned because they have a family history of prostate cancer, or a routine blood test came back suspicious for prostate cancer. They ask, “How can I know if I have cancer or not?”

A prostate biopsy is the only sure method for diagnosing prostate cancer, a disease that affects about 1 out of 6 men. When diagnosed early, however, there is a very high cure rate. Thus, early detection and proper diagnosis are extremely important. When there is a good reason to suspect that prostate cancer is present, we do a needle biopsy under either local or general anesthesia order to send prostate tissue samples to a laboratory where specially trained doctors can see if cancer cells are present, and how dangerous they might be.

Until very recently, prostate cancer was the only tumor cancer that was diagnosed by random luck. Today, prostate imaging is revolutionizing diagnosis. Advanced imaging maximizes biopsy accuracy by revealing the tumor’s location so we can target it. If a biopsy comes back positive for cancer, we are confident that we have correct results. We can now match the risk level of the cancer (low, intermediate, or high) with the most appropriate treatment—including Active Surveillance if the patient is low risk and wants to defer treatment. The prostate biopsy gives us key information so our patients have the best chance for 100% success with the highest quality of life.

When is a biopsy needed?

If cancer starts to grow in the gland, it gives clues that it is present. The most common clue comes from the PSA blood test. When the test reveals a rise in PSA, it’s because something is going on in the gland. It might be cancer, but it might also be an inflammation or the result of a noncancerous condition called BPH. There are ways to refine the information from the PSA by also checking what’s called the free PSA and the total PSA. We can also order deeper analysis such as the 4Kscore or the Prostate Health Index. Based on lab work, we can know whether a biopsy is needed.

When available, a special MRI scan of the prostate confirms lab work by showing any area of suspicion. Plus, we now have MRI images to use with a remarkable new technology called fusion guidance.

PSA Test for Prostate Cancer at Associated Urological Specialists

The advantages of prostate biopsy at Associated Urological Specialists

Our practice offers breakthrough MRI/Ultrasound Fusion Guided Biopsy, or simply fusion-guided biopsy. It “fuses” or merges the previously captured MRI tumor images with real time ultrasound right here in our practice while the patient is under general anesthesia. With fusion-guided biopsy, we direct needles directly into the tumor and its surrounding zone.

The advantages of fusion guidance include:

  1. Patient comfort
  2. Greatest likelihood of diagnosing the most aggressive cells in the tumor, for the most accurate diagnosis.
  3. Avoid overdetecting insignificant cancer that may not need treatment
  4. Avoid missing significant cancer that needs immediate, aggressive treatment

At Associated Urological Specialists, the well-being of each person matters to us. We take the whole person into account. Your personal preferences, lifestyle and relationships matter just as much to us as your health. We strive to take the fear out of the prostate biopsy and put the accuracy in. When you and our doctors have a true “portrait” of your prostate cancer, we work with you in a process of shared decision making, so that every choice along the way enhances not just your quantity of life, but also your quality of life.

If you or a loved one is concerned about prostate cancer, or would like more information, contact us at (708) 888-8287.