Indications for prostate biopsy

Prostate biopsy is used to confirm whether it is prostate cancer. In recent years, the incidence of prostate cancer has been increasing, and most of them are elderly people. Prostate cancer is a common disease in men.

Prostate cancer is a common malignant tumor that is very harmful to human health. Prostate puncture is very risky and needs to be done in a formal professional hospital.

This can reduce the risk and avoid affecting people's health.

Prostate cancer is one of the most common malignant tumors in men worldwide, and ranks first among men in the United States. In China, it is currently ranked about 6th among male malignant tumors in large cities, surpassing kidney cancer and bladder cancer, and is the most common cancer of the genitourinary system.

Fortunately, most prostate cancers are not very aggressive. If detected early, the 10-year survival rate can reach more than 95%. Even in the late stage, when the disease has already metastasized, many patients can still live for more than 5 years. I often tell my patients that if you have lung cancer or liver cancer that has metastasized to the bones, then treatment is really meaningless. However, if prostate cancer has metastasized to the bones, there is still a good chance of long-term survival after treatment.

What is the diagnosis of prostate cancer based on? Screening relies on blood tests for PSA (prostate-specific antigen), physical examinations rely on MRI and bone scans, and confirmation generally requires prostate puncture.

Prostate cancer puncture generally only requires local anesthesia. There are two puncture methods: perineal puncture and rectal puncture.

The overall risk is not very high. Transperineal puncture requires less preparation and can be performed almost as an outpatient. After the puncture, you can go home. Transrectal puncture is slightly more complicated, and the preparation and observation time are slightly longer. The main risks are:

1. Bleeding. Bleeding from puncture is common, usually manifested as hematuria and bloody stools after puncture, but it is not serious in most people and disappears on its own after 2-3 days.

2. Infection. This is the biggest risk, especially for transrectal puncture, where the incidence is higher, but it is less than 5%. Generally speaking, the symptoms of infection are fever, frequent urination, and painful urination. Most people have mild infections and get better after anti-infection. Some people have severe infections, even "septicemia", but if preventive measures are taken, the probability is not too high and timely treatment will not have too many consequences. I have participated in or seen thousands of prostate punctures, and there have only been 2 cases of severe infection, and both were cured in the end.

The risks of prostate puncture are mainly the above two, and others include allergies, false negative puncture results, etc.

Some people say that based on the results of MRI, PSA, bone scan, etc., prostate cancer has almost been confirmed, so why do we still need a biopsy?

For some elderly people, if the PSA index is very high and both MRI and bone scan are considered prostate cancer, then it can basically be diagnosed. However, we generally still recommend puncture in order to obtain more detailed information about the tumor.

Many prostate cancers are not very aggressive and patients can survive for a long time, but a small number are also very serious and develop very quickly.

Prostate cancer is divided into five groups in pathological grading, with Gleason scores ranging from 2 to 10. If the score is below 6 and it is in the early stage, then surgery, medication and other treatments may not be necessary. If the score is the highest, 10, then it can be predicted that the disease may develop rapidly in the short term. Therefore, in addition to confirming the diagnosis, the purpose of biopsy is to provide reference opinions on the treatment and prognosis of the tumor. Patients and their families can make recommendations based on the tumor.