Considering a prostate biopsy for your patient?
In a patient with findings suspicious for prostate cancer, a prostate biopsy is the only way to obtain a definitive diagnosis for your patient within a short timeframe.
The decision to proceed with a prostate biopsy is an individualized decision for you and your patient. Several factors may be considered in determining the best path of care, including screening test results, the existence of symptoms, and your patient’s risk factors and genetic history.
Elevated or rising PSA
A PSA test may help detect prostate cancer at an early stage, leading to a better outcome for your patient. However, views about PSA screening on its own and appropriate follow-up have been evolving.
In general, the higher your patient's PSA level, the more likely his chances to have prostate cancer. And a continuous rise in PSA levels may also be an indication of the presence (or recurrence) of prostate cancer, and the need to continue to the diagnosis stage – which may include a prostate biopsy (or repeat biopsy) to obtain more information about the presence and nature of the potential disease.
However, various factors can cause your patient’s PSA levels to fluctuate in addition to the presence of prostate cancer, including prostatitis, urinary tract infection, and benign enlargement, just to name a few. In addition, studies establishing a "normal" range of PSA levels have recently been deemed more subjective as opposed to an industry standard.
An elevated PSA alone, especially when no other symptoms of prostate cancer exist, may call for additional screening tests to ensure the next step in diagnosis is the right path for your patient. These may include one or more follow-up PSA tests and/or other screening tests such as a DRE or imaging studies to confirm the suspicion of potential cancer. If PSA levels remain high or continue to rise, or if other warning signs are detected through additional tests, a biopsy could be the next logical step in diagnosis and gathering essential information about your patient's specific prostate cancer.
The decision to proceed with a biopsy – better information leads to confident decisions
If you and your patient make the decision to proceed with a prostate biopsy, it’s important to note that the screening process may have detected smaller, slow-growing tumors that do not pose a real threat to your patient or create a need for aggressive treatment. In these cases, active surveillance may be the best option to mitigate treatment complications and potential side effects and preserve your patient’s quality of life. Although the prostate biopsy provides important diagnostic information specific to your patient’s disease, additional information is now available post-biopsy to complement your patient’s biopsy results and provide further detail and guidance to confidently inform your treatment decisions.
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