by De Ette Stewart

Created on: November 15, 2008   Last Updated: November 21, 2008

If you have had a persistently elevated PSA blood test (Prostate Specific Antigen), or an abnormal DRE (Digital Rectal Exam) by a doctor, you may have been asked to get a prostate biopsy.

The prostate gland is located behind and below your bladder, partially surrounding your urethra where it leaves the bladder. It is most accessible from the rectum. Most prostate biopsies are performed by way of a rectal approach using Ultra Sound guidance. This is known as a TRUS (Trans-rectal Ultra Sound) guided biopsy. The doctor will numb the area and use the Ultra Sound to show him where to insert the needle that samples the tissue.

The symptoms of early Prostate Cancer are nearly the same as a benign disorder known as BPH (Benign Prostatic Hypertrophy). The biopsy is necessary to rule out Prostate Cancer. While a PSA and DRE are both valuable tools, only a tissue sample can definitively indicate the presence of cancer. Your doctor will explain the details of the procedure and ensure you are well informed prior to beginning the biopsy. This can usually be performed in a Urologist's office as an outpatient.

The tissue samples will be forwarded to a physician specialist known as a Pathologist. This doctor will look at the tissue under a microscope and use special stains known as Immunohistochemical Stains in order to render an accurate diagnosis. He will look at a number of factors and assign a score to different aspects of the cells, such as the mitotic rate and degree of differentiation. This score is known as the Gleason Score. The closer the Gleason score is to ten, the more aggressive in behavior your cancer is likely to be. As the prostate is a large gland and cancer can occur at any place within it, your doctor will need to sample more than one area in order to give the Pathologist sufficient tissue with which to render an accurate diagnosis.

The results of the biopsy are usually available within a week or so. Your doctor may ask you to schedule a return visit to discuss the findings.

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