The Best Method For Conducting a Prostate Biopsy

 From the book
“The Best Options for Diagnosing & Treating Prostate Cancer"
by James Lewis, Jr. Ph.D. Survivor and Author

Since the 1980’s the ability to diagnose prostate cancer has been enhanced significantly by the advent of the prostate specific antigen (PSA) test. By taking a PSA level and performing a digital rectal exam on an annual basis, physicians are now able to detect prostate cancer at an early stage (when it is confined to the prostate). Such early detection may represent the best chance for cure and for decreasing morbidity and mortality from this terrible disease. The sextant biopsy, which is usually guided by a transrectal ultrasound machine, has detected a large number of cases of prostate cancer. However, one research study has indicated that the sextant biopsy misses about 22 percent of the cancers. Many physicians have felt that six-tissue extractions of the prostate gland are not enough, and they have increased this figure to seven, eight, and even higher. Depending on the number of suspicious areas, one doctor may take as many as 18 samples from a patient.

At least one urologist uses magnetic resonance spectroscopic imaging (MRSI) to guide where he performed the biopsy of the patient for better coverage.

Urologists at the Bowman Gray School of Medicine of Wake Forest University at Winston-Salem, North Carolina, have discovered a technique known as the 5- region prostate biopsy. It is superior to the sextant biopsy and represents, to this author, the best approach for conducting a prostate biopsy.

A study was conducted to determine if additional biopsies performed in areas of the prostate beyond those sampled by the sextant biopsy increased the detection of prostate cancer. A total of 119 patients underwent transrectal ultrasound-guided needle biopsy. In addition to sextant biopsies, cores were taken from the lateral and middle regions of the prostate gland. Pathological findings of the additional regions were analyzed and compared to these of the sextant biopsies. Of the 119 patients, 48 (40%) had prostate cancer. Of these 48 patients, 17 (35%) had cancer only in regions 1,3,and 5 (right lateral, middle, and left lateral lobes). These tumors would have been missed had the sextant biopsy been used alone.