Understanding Your Prostate Biopsy

1. What is my prostate?
   Your prostate gland is located at the base of your urinary bladder. It wraps around the upper part of the urethra (the tube that carries urine from your bladder through the penis to outside the body). The prostate produces fluid which combines with sperm in the urinary tract to make semen.
2. What does PSA mean?
   PSA is a protein produced by the prostate gland. Your PSA level (amount) is determined from your blood sample and may be used to help monitor your prostate. A high PSA level does not necessarily mean cancer is present. Many things can raise the PSA level such as inflammation, infection, sexual intercourse, and recent manipulation of the prostate (ie. ultrasound, biopsy, cystoscopy, or colonoscopy). It is best to inform your physician of any additional testing which may be scheduled at the time your blood is being drawn to check your PSA.
3. Does an increase in my PSA mean that I have prostate cancer?
   A high PSA level does not necessarily mean cancer is present. Many things can raise the PSA level such as inflammation, infection, sexual intercourse, and recent manipulation of the prostate (ie. ultrasound, biopsy, cystoscopy, or colonoscopy). It is best to inform your physician of any additional testing which may be scheduled at the time your blood is being drawn to check your PSA.
4. My PSA is higher than my friend's PSA. He has prostate cancer. Does this mean I have prostate cancer?
   A high PSA level does not necessarily mean cancer is present. Many things can raise the PSA level such as inflammation, infection, sexual intercourse, and recent manipulation of the prostate (ie. ultrasound, biopsy, cystoscopy, or colonoscopy). A high PSA will most likely require further evaluation to determine if prostate cancer is present.
5. If I have a normal PSA, does this mean that I have nothing to worry about?
   If you have a normal PSA, you should continue to have your PSA checked in additional to a digital rectal exam. During the digital rectal exam, your physician will feel the rear surface of your prostate. If there is an abnormality present during the digital rectal exam, further investigation may be required.
6. Will having a larger prostate make it more likely that I will get prostate cancer?
   An enlarged prostate will not increase your risk of being diagnosed with prostate cancer.
7. If I have trouble urinating, is this a sign that I have prostate cancer?
   There are no symptoms specific for prostate cancer. It is possible to have prostate cancer for many years without symptoms. Difficulty urinating can be symptom of either an enlarged prostate or an abnormal bladder. Further testing such as PSA, digital rectal exam, and/or prostate ultrasound may be necessary.
8. Does having a prostate ultrasound done mean that I automatically will have a prostate biopsy done?
   Having an ultrasound scheduled does not always mean a biopsy will be done. A prostate ultrasound will allow your physician to see images/pictures of your prostate. An ultrasound probe will be placed in your rectum to produces these pictures. This should not be painful though many patients say that they experience great deal of pressure in the rectum. When a prostate biopsy is necessary, it will be done at the same time as the ultrasound.
9. Will prostate ultrasound find all prostate cancers?
   An ultrasound will not find all prostate cancers. Areas of the prostate with cancer can look darker, lighter, or the same as normal prostate tissue on ultrasound pictures.
10. How are the prostate biopsies done?
    Prostate biopsies are done in the office. You will be awake during the procedure. A prostate ultrasound will be done first to guide the placement of the biopsy needles. The needles allow your physician to take a small amount of the prostate tissue. The tissue samples will then be sent to a laboratory for diagnosis.
11. Are prostate biopsies painful?
    Though you may feel some mild discomfort, you should not experience severe pain. Comments from our patient include:
    • It was not as bad as they had anticipated
    • It felt like a rubber band being snapped
    • Like a bee sting
12. How many biopsy samples are taken?
    There is no set number of biopsy samples. They can range from two to eight samples. Tissue samples from different parts of the prostate may be obtained to create a "map" of your prostate.
13. Can a prostate biopsy spread prostate cancer?
    No, there is no scientific evidence that shows that biopsies spread cancer.
14. Can I drive home after the biopsy?
    In most cases, patients are able to drive home without problems. However, if you have taken a sedative before your biopsy, you will need someone to drive you home.
15. What should I expect after my biopsy?
    You may feel mild discomfort at the site of the biopsy. This should not last long and can be treated with over the counter medications. You can see some blood in the stool, urine, and semen. While the bleeding usually resolves quickly, some bleeding can be expected up to six weeks. Serious bleeding is rare. You should call if you are experiencing heavy bleeding or passage of blood clots in the urine. If you are taking anti-coagulants (blood thinners), please let your physician know before the biopsy.
16. Can I get a prostate infection from the biopsy?
    You will be given antibiotics to take after the biopsy in order to prevent an infection. Please make sure you take all the doses given. If you experience a fever or difficulty urinating, please contact us even if you have taken the antibiotics.
17. Should I restrict my activities?
    For most patients there are no limitations to their usual activity following a prostate biopsy. The biopsy should not affect you sexually though there may be blood in your semen. If you have questions about particular activities, double check with your physician.
18. When will my biopsy results be available?
    The results are typically available in three to five business days. If you do not hear back from our office within that time period, please call our office. It is never good to assume no news is good news. Always get your results.
19. Will you send a copy of my biopsy results to my primary care doctor?
    The biopsy results will be sent to your primary care physician. Make sure you let the technician know whom you would like to send a copy of the results.