Ending Uncertainty and Anxiety from Repeated False Negative Biopsies.

The standard biopsy method for prostate cancer, known as the transrectal (TRUS) biopsy, is an imperfect diagnostic tool. Between 10 and 30 per cent of men with prostate cancer present will be given a negative biopsy result.

This false-negative rate is challenging and unacceptable for both patient and the urologist. The patient’s rising PSA will tell the urologist he is at high risk of prostate cancer, but one or more biopsies will fail to detect cancer. The patient will have to endure the discomfort of repeated biopsies and rising anxiety from an uncertain situation.

The TRUS biopsy involves inserting an ultrasound probe into the back passage (rectum). A needle is then placed down the shaft of the probe, through the wall of the rectum and into the prostate.

This takes place under the guidance of the ultrasound image on a screen. Although this image helps us to measure the size of the prostate, it lacks detail and precision. Needles are inserted in between six and 12 different places, with the aim of ensuring all areas of the gland are sampled. Even in experienced hands, it is inevitable that for some patients, the needle will miss the cancerous sections of the prostate.

The template biopsy offers a different approach which is particularly relevant to men who have had repeated negative TRUS results but are considered at high risk of prostate cancer.

It is different to the standard TRUS biopsy in two ways. The term ‘template’ refers to a plate which is used to provide precise mapping of the prostate. It was originally developed for brachytherapy, during which needles are inserted through holes in the template to exactly position radioactive seeds within the prostate.

By using the same template during a biopsy, the urologist is able to accurate map where each tissue sample is taken from and ensure the entire prostate is sampled. The template biopsy is also carried out at a different angle to the TRUS procedure. The needles are inserted through the perineum (the area between the scrotum and anus) which means there is less bleeding and discomfort.

The angle of a template biopsy also allows for improved sampling of the central and anterior sections of the prostate than a TRUS approach.

Template biopsy was first introduced in America and is gradually being introduced in a small number of specialist urological centres now in the UK. Evaluations of its effectiveness are very promising. One study, entitled Evaluation of a novel precision template-guided biopsy system for detecting prostate cancer* involving 140 patients concludes: “Template-guided biopsy potentially produces a higher cancer detection rate and more accurate assessment of grade.”

It is important to note that template biopsy should not be the first line diagnostic test for prostate cancer. For the majority of patients, a TRUS biopsy will be an effective diagnostic tool. But for those high risk patients with repeated negative tests, template biopsy offers an important and valuable new method.

Study authors: Ifeanyichukwu I. Megwalu, Genoa G. Ferguson, John T. Wei , Vladimir Mouraviev , Thomas J. Polascik, Samir Taneja, Linda Black, Gerald L. Andriole and Adam S. Kibel Division of Urology, Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, Department of Urology, University of Michigan School of Medicine, Ann Arbor, MI, Division of Urology, Duke University School of Medicine, Durham, NC, and Department of Urology, New York University School of Medicine, New York, NY, USA

Author Bio: Derek Rogers is a freelance writer who writes for a number of UK businesses. He recommends Birmingham Prostate Clinic who specialise in the new Prostate Template Biopsy assessment.

Category: Medicines and Remedies
Keywords: Prostate Cancer,Prostate Biopsy,Biopsies,Prostate Cancer Testing,TRUS Biopsy