Is biopsy necessary & effective for detecting prostate cancer?

@brianjarvis
Have been on AS for the year. Hoping for continued low #s!

My biopsy was transrectal & had no post-procedure blood in feces or urine. It was a non-event.

@surftohealth88 You ain’t kiddin Surf! I was in the room with my wife when she had one after a slightly suspicious PAP smear.
It was really medieval and when we both asked the Gyno (an old SOB) why there was no anesthetic of ANY kind he shrugged and simply said, “Well, we just don’t use it”…thanks, pal…
Phil

Not much to add...

Here are some links to "ways" to diagnosis if one has PCa:
https://www.medpagetoday.com/urology/prostatecancer/118778
https://www.google.com/gasearch
https://www.google.com/gasearch
https://www.google.com/gasearch
https://pmc.ncbi.nlm.nih.gov/articles/PMC4495493/
Kevin

I have heard horror stories about TRUS. Some are apparently tolerable but i recommend transperineal.

My transperineal biopsy lasted just over 5 minutes. (My surgeon is extremely skilled and efficient.)

Afterwards, for his records, he asked for my responses. "Rate your pain level 1-10." I said 2. Rate your discomfort level." I said 4.

I assume your Urologic Oncologist will perform the biopsy, not a general urologist.

I had minimal pain and bleeding afterwards and only for a couple of days. Yours could be different but you should be fine.

@heavyphil

I was alone : (((, did not expect that doctor would "offer" to do it right there and was stupid to trust her that "it is just like some pinching feeling and some pressure" - well it was excruciating : (((... I was silently whimpering and when she was done I told her that it was horribly painful and that I am sorry that I made some muffled squeaking ( yeah, I am idiot like that, always feel need to apologize even when somebody is torturing me *sigh), and she said nonchalantly :
"Oh, you did GREAT ! I had many ladies jump off the table screaming " !

O_O (????? ) I was so much in shock, I honestly felt violated : (((. I needed 2 days to calm down and relax, my whole body was in some kind of total muscle spasm and my heart was racing whole night.

While I was growing up my mother was always telling me that most doctors have compassion of a "butcher" and I unfortunately experienced that "compassion" more than once in my life : (((.

MRI can only identify suspicious areas which could be caused by inflammation or benign lesions, or possibly cancer. Only a biopsy allows samples to be extracted and then tested by a patholgist to determine if the lesion is cancerous, and if so what grade. Many medical centers perfom biopsies under anesthesia, so it does not feel "barbaric". I have had 6 biopsies over the years three of which were under anesthesa and the three others without. I was able to tolerate even the biopsies without sedation since they typically use local anesthetics like lidocaine injected into the perenium or prostate area. There is some discomfort for sure, but I was able to tolerate it.

@surftohealth88 So damned familiar - every time my wife gasped, the doctor muttered , ‘yes, yes, a little pinch, yes…’
I wanted to ‘pinch’ his friggin nose but, like you, I was still obeying the rules I was taught…girl, those days are over!
Phil

I lost a friend from transrectal biopsy. He died of sepsis. I was more than nervous so I moved to a more sophisticated facility but was not offered perianal. The antibiotic worked and I had zero after effects. The biopsy definitively diagnosed my cancer and was the basis for next treatments. Transrectal carries coliforms inside your body cavity with the needle effectively seeding infection it’s a miracle that so few after effects occur. I vote perianal for that reason.

@billfarm These days, transperineal prostate biopsies are the way to go. Earlier last year when my oldest brother was diagnosed with prostate cancer, we rejected two urologists because they would only do TRUS biopsies on him.

And yet, during the time that I was on active surveillance (2012-2021), I had 4 TRUS biopsies - never had any complications.

Also note that there is still a risk of infection with transperineal prostate biopsies, but it’s much less than TRUS biopsies. (< 5% for transrectal; < 1.1% for transperineal.)

On the other hand, though the incidences of needle-track seeding are rare, a 2015 paper reported more incidences of needle-track seeding after transperineal biopsies of the prostate, than after transrectal biopsies.