Where is the prostate
is a walnut shaped gland present only in men; it is located
just below the opening of the bladder and encircles the water
tube (urethra) that carries urine and semen.
PSA levels are raised and I need a biopsy, so what happens
is carried out in a special clinic which is currently held
in ward 14 BRI. Even patients seen at the Yorkshire Clinic
come to BRI as we have the latest high quality equipment in
this clinic. You will be admitted to the York
Suite if you have been seen at the Yorkshire Clinic in the
performed as an outpatient procedure. It does not require
an anaesthetic and you will be able to go home shortly after
the procedure is completed.
be asked to lie on the examination couch while the doctor
re-examines your prostate to assess it. The doctor will then
scan the prostate by inserting a small ultrasound probe into
the rectum. An ultrasound probe in the rectum enables the
specialist to 'see' the prostate in such a way that needle
biopsies may be taken with greater accuracy from different
parts of the prostate. The diagnosis of prostate cancer is
made by the histological examination of prostate tissue, and
the standard investigation for a man with a raised serum PSA
is the taking of several needle biopsies under transrectal
ultrasound (TRUS) control.
are taking Aspirin, Clopidrogel or Warfarin you should have
been advised about stopping the drugs. Please speak to Mr.
Puri or the specialist nurse for advice, Patients
report that TRUS biopsies are moderately uncomfortable. As
there is a risk of infection, antibiotics are prescribed to
cover the procedure.
3 in 100 will require a second course of antibiotics,
- 1 in
100 will have to be admitted to hospital for intravenous
risk of death from TRUS biopsy is less than 1 in 10,000.
may have some bleeding in the urine or following sexual
intercourse for up to three weeks.
60-70% of men undergoing TRUS biopsy for a raised PSA are
to have cancer. This proportion differs according to the 'threshold'
PSA that is considered to be abnormal.
biopsy was negative, what happens now?
is very difficult to answer accurately, but the important
thing to note is that a negative biopsy result cannot exclude
completely the possibility of cancer within the prostate.
If the amount of cancer is very small it is difficult to hit
it with the biopsy needle.
practice is to keep you under review by regular visits to
the outpatient department and to repeat the PSA at intervals.
If the PSA continues to climb steadily upwards this would
be further evidence of possible cancer and it might be necessary
to repeat the biopsies. This would not be done within three
months because the act of taking a biopsy from the prostate
artificially raises the PSA level and this would confuse the
PSA levels remain stable it may be possible for your GP to
repeat the test
at regular interval.
this leaflet provides useful information that will help you
understand the reasons for the various tests. If you have
any questions, jot them down here and ask the nursing or medical
staff for answers.
here to go back to the Prostate Cancer Main Menu