Patient Information

Examination/Diagnosis

The Biopsy

The diagnosis of prostate cancer is usually done by taking samples of the prostate and examining the tissue under a microscope. The tissue is obtained by a urologist in his office by taking needle biopsies through the wall of the rectum. This is usually done with the assistance of an ultrasound probe which is inserted in the rectum, just behind the prostate. Sound waves bounce back and form a picture of the prostate. The doctor may then visually guide his needle to the areas he plans to take a biopsy. About a dozen samples are taken from the prostate gland through a thin needle – about six from each side. If the procedure is performed through the rectum, antibiotics are prescribed to prevent infection. An enema may also be prescribed for the morning of the procedure. This procedure is slightly uncomfortable as the probe is inserted into the rectum. There is local anesthetic administered prior to the procedure to make it less uncomfortable. The tissue is then sent to a lab where a pathologist examines it carefully.

Further Testing

If the biopsy confirms prostate cancer, your urologist may order some tests to see if the cancer has invaded any surrounding tissue or spread to other parts of the body. This usually involves having a CT scan done and or a bone scan.

A bone scan is done to detect any tumor, which has spread to the bone. A small amount of radioactive tracer is injected into a vein. This travels throughout the blood stream and collects in the bones. A machine called a scanner moves over the entire body taking pictures of the bones on a computer screen. The tracer settles in areas of the body where bone is changing or growing rapidly. Cancer is not the only reason this substance collects in the bone. Old fractures, arthritis and previous injury can show up also.

A second test your doctor may order is a CAT scan of the abdomen and pelvis. This uses a computer to combine X-Ray images in a three dimensional view of an organ. These scans may show if there are any enlarged pelvic lymph nodes which could be an area of concern.