NCCN Guidelines for Patients® | Prostate Cancer - page 11

NCCN Guidelines for Patients
: Prostate Cancer
Version 1.2014
Part 2: Cancer staging
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Local anesthesia:
A loss of
feeling in a small area of the
body caused by drugs
The last part of
the large intestine
2.3 Prostate biopsy
Rising PSA levels and abnormal DRE findings may suggest cancer is present.
However, the only way to know if you have prostate cancer is to remove tissue
from your body and have a pathologist examine it under a microscope. A biopsy
is a procedure that removes small samples of tissue for testing. Biopsies can
also help your doctor assess how far the cancer has grown.
A prostate biopsy is a type of biopsy that removes tissue from the prostate. To
prepare for the biopsy, your doctor may say to stop taking some medications
and start taking others. Medications to stop taking include blood thinners like
warfarin (Coumadin
) or antiplatelet drugs like aspirin or Plavix
. Your doctor
may prescribe antibiotics to try to prevent an infection from the biopsy.
Right before the biopsy, local anesthesia may be given to numb the area. You’ll
feel a small needle stick and a little burning with some pressure for less than a
minute. A numbing gel may also be applied to the area. You may feel pressure
and discomfort during the biopsy but pain is often minimal or none.
The most common type of prostate biopsy is the transrectal method. To make
sure the best samples are removed, a TRUS probe is inserted into your rectum.
The TRUS uses sound waves to make a picture of your prostate that is seen by
your doctor on a screen. Next, a spring-loaded needle will be inserted through
the TRUS. Your doctor will trigger the needle to go through the rectal wall and
into your prostate.
The needle removes tissue about the length of a dime and the width of a
toothpick. At least 12 samples—called cores—are often taken. This is done
to check for cancer in different areas of the prostate. Prostate biopsies aren’t
perfect tests. They sometimes miss cancer when it’s there. If no cancer is
found as well as no other cause for the high PSA, your doctor may order more
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