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Neighborhood Blog

Before you get a prostate biopsy…

man talking to doctor

Approximately 175,000 men in the United States will be diagnosed with prostate cancer, and 32,000 will die from it. It’s a cancer that is as common in men as breast cancer is in women.

There are over 1 million trans-rectal ultrasound (TRUS) prostate biopsies performed on American men each year. Unfortunately, these biopsies can have some very unpleasant side effects, including rectal bleeding, tenderness and pain, sexual dysfunction, infection, painful urinating, and blood in the urine or semen for up to 6 weeks after the procedure.

More importantly, a TRUS biopsy can easily miss prostate cancer. Because it samples less than 1% of the prostate gland, it is only able to diagnose cancer in 40% of cases when it is present.1 It also tends to under-diagnose clinically significant disease and over-diagnoses non-threatening disease.

Thanks to a new tool called multiparametric prostate MRI (mpMRI), the number of prostate biopsies could be reduced by 50%.2

mpMRI is an exciting new tool that can detect, localize and characterize prostate cancer. Translated into English: It’s a test that could help you avoid a prostate biopsy, or if a biopsy is needed, it can help to improve its accuracy.

A more precise imaging modality than ultrasound, mpMRI is capable of distinguishing between cancerous and non-cancerous prostate tissue. It can rule out prostate cancer, which means that a biopsy need not be performed. If mpMRI does identify a suspicious area, the images can be “fused” with the ultrasound used in a TRUS biopsy to improve its accuracy.

The American Urological Association now recommends mpMRI in men with two or more risk factors for prostate cancer, including:

  • A positive digital rectal exam
  • A Gleason score of 7 or higher
  • A rising PSA or PSA greater than 10
  • Suspected prostate cancer but have had repeated negative biopsy
  • Confirmed prostate cancer (for cancer staging and monitoring)
  • Those under active surveillance

This “Movember” some of our male staff have elected to grow moustaches to help bring awareness to prostate and testicular cancer, and to promote screening for their early detection. They also want to encourage men to do their own homework, to learn about mpMRI and to talk to their doctor about it if they are at risk or if they’ve been told they need a prostate biopsy.

mpMRI isn’t right for all men, but if you’re at risk for prostate cancer, it is really worth your time to learn more.

  1. Heidenreich A, Bastian PJ, Bellmunt J, et al. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent--update 2013. Eur Urol. 2014;65:124-3
  2. Comparison of Multiparametric Magnetic Resonance Imaging and Targeted Biopsy With Systematic Biopsy Alone for the Diagnosis of Prostate Cancer: A Systematic Review and Meta-analysis. Martha M. et al, JAMA Netw Open. August 7, 2019;

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