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Is The Prostate Cancer Biopsy An Effective Diagnostic Tool?

Although there are a number of different tests which may be undertaken if prostate cancer is suspected, the one certain way to detect the disease is through a prostate biopsy. But exactly how effective is the biopsy at confirming this particular disease?

In the US alone every year there are approximately one million prostate biopsy procedures performed of which approximately 25 percent indicate the existence of prostate cancer. But, of the other 75 percent of prostate biopsies roughly 33 percent result in false negative results. This means that about 25 percent of all those men being given prostate biopsies are cleared by this test, despite the fact that they are suffering from prostate cancer.

On the surface therefore it could appear that the prostate biopsy is not a very good test but the results do not demonstrate that there is anything wrong with the biopsy as a tool for confirming prostate cancer. What it does clearly show however is that there is a need to spot those patients who, although they have returned negative results, are nevertheless at considerable risk from prostate cancer and ought therefore to be given a follow-up biopsy.

The difficulty is that until very recently there has been no simple method of identifying those patients who are at risk. Fortunately, a study of more than five hundred individuals being investigated for prostate cancer might now provide an answer.

All of the men taking part in the study had already received a negative prostate biopsy result but researchers discovered that when they looked at the patient's PSA test results and adjusted these for the size of the prostate gland they were able to identify those patients who were likely to receive positive results on a follow-up biopsy.

The researchers also found that men with a Gleeson score of 7 or higher were at greater risk from life-threatening prostate cancer and were again more likely to receive a positive result from a second biopsy. The Gleeson score is measured on a scale from 2 to 10 and the score is calculated from a microscopic investigation of prostate biopsy tissue. A low score shows cancer with a low risk of spread while high scores show cancer that is far more likely to spread.

There are a number of different prostate biopsy procedures available today although possibly the most frequently performed procedure is known as the core needle biopsy. In this case a number of tiny samples of tissue are removed from different parts of the prostrate gland using a biopsy gun that fires a needle into the selected area and removes the sample in just a fraction of a second. These samples are then sent off for microscopic analysis to establish whether cancer is present and, if so, to determine exactly how much of the prostate gland is affected.

A prostate biopsy is an expensive procedure and is a test that can be reasonably nerve-racking for the patient. It is sometimes also a quite painful test that may involve bleeding and the risk of infection. As a result it is in everyone's interest to identify those individuals for whom a second biopsy is advisable and to reduce as far as possible the number of avoidable follow-up biopsies being done each year.