Is The Prostate Cancer Biopsy An Effective Diagnostic Tool?

Though there are a number of different tests which may be undertaken if you suspect the presence of prostate cancer, the one sure way to confirm the condition is through a prostate biopsy. But precisely how successful is the biopsy at diagnosing this particular disease?

In the United States alone each year there are about 1,000,000 prostate biopsy procedures carried out of which some 25 percent indicate the existence of prostate cancer. But, of the remaining 75 percent of prostate biopsies about 33 percent indicate false negative results. This means that about a quarter of all men having a prostate biopsy are being cleared by this test, notwithstanding the fact that they have prostate cancer.

At first sight therefore it could appear that the prostate biopsy is not a very efficient test but the results do not show that there is anything wrong with the biopsy as a means of identifying prostate cancer. What it does clearly show however is that there is a need to recognize those men who, despite they have returned negative results, are nonetheless at considerable risk from prostate cancer and should therefore have a second follow-up biopsy.

The difficulty is that until recently there has not been a simple way of identifying patients at risk. Fortunately, a recent study of over five hundred individuals being investigated for prostate cancer could now provide a solution.

All of the patients investigated in the study had already had a negative prostate biopsy result but researchers discovered that when they studied the men's prostate specific antigen test results and these were adjusted to take account of the size of the prostate gland they could identify those men who were likely to show a positive result on a second biopsy.

The researchers also noted that patients with a Gleeson score of 7 or higher were at an increased risk from life-threatening prostate cancer and were once again more likely to record a positive result on a further biopsy. The Gleeson score is measured 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 small risk of spread while high scores show cancer which is much more likely to spread.

There are a number of different prostate biopsy procedures in use today although possibly the most common procedure is known as the core needle biopsy. Here several tiny samples of tissue are taken from different sections of the prostrate gland using a biopsy gun which shoots a needle into the chosen area to remove the sample in a fraction of a second. The samples collected are then sent off for laboratory analysis to find out whether or not cancer is present and, if it is, to work out precisely how much of the prostate gland is affected.

The prostate biopsy is a costly procedure and is a test which can be relatively distressing for the subject. It can also be a fairly painful test which may involve bleeding and the risk of infection. For these reasons it is in everyone's interest to pinpoint those individuals for whom a follow-up biopsy would be prudent and to reduce the number of needless follow-up biopsies being performed each year.