Can Prostate Biopsy Cause Erectile Dysfunction
If are recommended by your doctor to undergo prostate biopsy procedure for the detection of cancer, you must have a lot of questions and reservations. One of the most common question that people usually have is, can prostate biopsy cause erectile dysfunction or alter the quality of sex life at all?
The answer is yes erectile dysfunction may occur after prostate biopsy in some susceptible individuals but it is usually transient and self-limiting.
Accorded to a study published in the Journal of Urology, men who undergo prostate biopsy are at risk of temporary erectile dysfunction due to anxiety or pain however, in most men, symptoms improve within a couple of weeks.
How Is Prostate Cancer Diagnosed
A biopsy is when a small piece of tissue is removed from the prostate and looked at under a microscope.
A biopsy is a procedure that can be used to diagnose prostate cancer. A biopsy is when a small piece of tissue is removed from the prostate and looked at under a microscope to see if there are cancer cells.
A Gleason score is determined when the biopsy tissue is looked at under the microscope. If there is a cancer, the score indicates how likely it is to spread. The score ranges from 2 to 10. The lower the score, the less likely it is that the cancer will spread.
A biopsy is the main tool for diagnosing prostate cancer, but a doctor can use other tools to help make sure the biopsy is made in the right place. For example, doctors may use transrectal ultrasound or magnetic resonance imaging to help guide the biopsy. With transrectal ultrasound, a probe the size of a finger is inserted into the rectum and high-energy sound waves are bounced off the prostate to create a picture of the prostate called a sonogram. MRI uses magnets and radio waves to produce images on a computer. MRI does not use any radiation.
Lymph Node Biopsy As A Separate Procedure
A lymph node biopsy is rarely done as a separate procedure. Its sometimes used when a radical prostatectomy isnt planned , but when its still important to know if the lymph nodes contain cancer.
Most often, this is done as a needle biopsy. To do this, the doctor uses an image to guide a long, hollow needle through the skin in the lower abdomen and into an enlarged node. The skin is numbed with local anesthesia before the needle is inserted to take a small tissue sample. The sample is then sent to the lab and looked at for cancer cells.
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Questions To Ask The Doctor
- What treatment do you think is best for me?
- Whats the goal of this treatment? Do you think it could cure the cancer?
- Will treatment include surgery? If so, who will do the surgery?
- What will the surgery be like?
- Will I need other types of treatment, too?
- Whats the goal of these treatments?
- What side effects could I have from these treatments?
- What can I do about side effects that I might have?
- Is there a clinical trial that might be right for me?
- What about special vitamins or diets that friends tell me about? How will I know if they are safe?
- How soon do I need to start treatment?
- What should I do to be ready for treatment?
- Is there anything I can do to help the treatment work better?
- Whats the next step?
What Is A Trus Biopsy
This is the most common type of biopsy in the UK. The doctor or nurse uses a thin needle to take small samples of tissue from the prostate.
Youll lie on your side on an examination table, with your knees brought up towards your chest. The doctor or nurse will put an ultrasound probe into your back passage , using a gel to make it more comfortable. The ultrasound probe scans the prostate and an image appears on a screen. The doctor or nurse uses this image to guide where they take the cells from. If youve had an MRI scan, the doctor or nurse may use the images to decide which areas of the prostate to take biopsy samples from.
You will have an injection of local anaesthetic to numb the area around your prostate and reduce any discomfort. The doctor or nurse then puts a needle next to the probe in your back passage and inserts it through the wall of the back passage into the prostate. They usually take 10 to 12 small pieces of tissue from different areas of the prostate. But, if the doctor is using the images from your MRI scan to guide the needle, they may take fewer samples.
The biopsy takes 5 to 10 minutes. After your biopsy, your doctor may ask you to wait until you’ve urinated before you go home. This is because the biopsy can cause the prostate to swell, so they’ll want to make sure you can urinate properly before you leave.
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Controversies And Misconceptions Surrounding Prostate Biopsies
The PSA test measures the levels of PSA proteins in the body, and when it was first developed, it was quickly implemented by many physicians as a screening test for prostate cancer. The thought was that since PSA proteins are only produced by the prostate, elevated levels could be an indication of prostate cancer. As a result, most men with an abnormal PSA test underwent a prostate biopsy.
The increase in biopsies resulted in the number of advanced, untreatable prostate cancers decreasing significantly because more prostate cancers were caught earlier, when the disease is easier to treat. But the problem with many patients being diagnosed sooner was that some patients were being aggressively treated when they should have been monitored instead.
Though many in the field of urology believe it was flawed, a controversial study attempted to assess the benefits of the PSA test as a screening tool for prostate cancer, and its results led to the recommendation that most men shouldn’t get the test because it didnt appear to improve mortality rates from prostate cancer. This, combined with growing awareness that many cases of prostate cancer were being treated unnecessarily or prematurely, led to a reduction in prostate biopsies. This controversy led to a reduction in prostate cancer screening and an increase in the number of diagnoses of advanced prostate cancer.
About Dr Dan Sperling
Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.
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Is There A Cure For Prostate Cancer
Although there is currently no cure for metastatic prostate cancer, new therapies are constantly being worked on and improved upon. As with all cancers, these treatments affect men differently based on their overall health, the extent of the cancer and the types of treatments you receive.
In this article on tips for preventing prostate cancer 7 , youll find evidence that suggests diet plays a key role in prostate cancer and the spread of prostate cancer.
Based on the evidence, a few diet tips include:
Home remedies for prostate cancer are often considered a complementary treatment to keep prostate cancer from spreading or to manage the side effects. In addition to a healthy diet, these treatments include essential oils, cannabis and herbal supplements, or plant extracts.
How Is It Diagnosed And How Fast Does It Grow
Prostate cancer often grows slowly, and most men with early-stage prostate cancer dont notice any symptoms. Symptoms are often noticed later on as the cancer grows. The signs include trouble urinating, blood in the urine, erectile dysfunction, and pain in the back, hips, ribs, or other bones.
According to the American Cancer Society 3 , prostate cancer tests include the following:
Though there are plenty of tests that one can go through to check if you have prostate cancer, there are other ways of how to check for prostate cancer at home.
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Can Biopsies Spread Cancer
Not every cancer situation lends itself to a biopsy. But when it does, and your doctor suggests one, you may have a decision to make. Is it in your best interest? Are there risks? For instance, can biopsies spread cancer? This is important to know since many cancer patients opt for biopsies whether they are using conventional or alternative cancer treatments.
Why Are Biopsies Potentially Dangerous
Metastasis The Biggest Danger of Biopsies. Puncturing the tumor can result in the release in micrscopic quantities of cancer cells into the surrounding lymphatic system of blood vessels. This can allow the cancer cells to move to distant organs and grow.
Prostate Cancer. Prostate cancer biopsies require needle aspirations of up to 30 different samples, which means thirty different punctures, and thirty opportunities for cancer to spread. Additional complications include the prevalence of antibiotic resistant sepsis, a potentially lethal blood infection, in patients undergoing prostate biopsies.
Breast Cancer. Breast cancer biopsies have been associated with complications such as pain, swelling, bleeding and drainage from the biopsy site. This can lead to infections. False positives are also prevalent from biopsies, resulting in unnecessary treatments. Dr. Vincent Gammill from the Center for the Study of Natural Oncology in Solana Beach, California, reported the case of a woman who had successfully battled breast cancer since 1994 with natural methods. She was convinced to do a needle biopsy by an oncologist, and now she has new tumors growing at each of the puncture sites. Dr. Gamill states that he rarely sees distant metastasis until after a biopsy, but following that it grows rapidly, especially in the bones.
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What Will Happen After Treatment
Youll be glad when treatment is over. But its hard not to worry about cancer coming back. When cancer comes back it is called a recurrence. Even when cancer never comes back, people still worry about it. For years after treatment ends, you will see your cancer doctor. At first, your visits may be every few months. Then, the longer youre cancer-free, the less often the visits are needed.
Be sure to go to all follow-up visits. Your doctors will ask about your symptoms, examine you, and might order blood tests and maybe other tests to see if the cancer has come back.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us at 1-800-227-2345 or talk to your doctor to find out what you can do to feel better.
You cant change the fact that you have cancer. What you can change is how you live the rest of your life, making healthy choices and feeling as good as you can.
Needle Tracking Of Prostate Cancer Cells During Prostate Biopsy: A Review
A new review article in BJU International has addressed the perennial question of whether prostate biopsy is associated with a risk for spreading of the cancer as a consequence of so-called needle tracking of prostate cancer cells.
Volanis et al. conducted a thorough search for published papers that addressed such issues as incidence of seeding, clinical presentation, and associated risk factors . Here is the quick summary of their findings:
- A total of 26 published papers were identified that report needle tracking and seeding of prostate cancer post-biopsy.
- These 26 papers reported that seeding occurred in just 42 patients.
- 9 such cases occurred after transrectal biopsy.
- 33 such cased occurred after transperineal biopsy.
In other words, while it is certainly possible for a biopsy to cause seeding of prostate cancer along the track of a biopsy needle under rare circumstances, there is almost no evidence at all to suggest that such seeding has ever led to the true spread of prostate cancer.
Furthermore, as the authors also note, even though over the past 20+ years there has been a massive increase in the number of prostate biopsies carried out each year, and a similarly massive increase in the number of biopsy cores taken, there is no evidence whatsoever to suggest that this is associated with any increase in reports of seeding.
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Who Should Have Focal Therapy
Candidates for focal therapy must be carefully selected, most often based on well-performed, image-guided biopsy techniques . Patients with intermediate-grade tumors visible in a single location on imaging may be considered for focal therapy. Low-grade cancers can be treated this way but are usually more suitable for active surveillance. Some doctors feel that cancer close to the urethra can also be treated in this fashion, but there may be a higher risk of side effects or incomplete treatment. Some feel that additional candidates for focal therapy include patients with one dominant tumor as described above and a microfocus of low-grade disease elsewhere. These smaller cancer foci are followed through active surveillance.
Results of ablation therapies to date have been favorable, but the experience and time of follow-up are still limited. In addition, these patients must be evaluated carefully to avoid undertreating their cancer, and after treatment, they need to have periodic imaging, PSA assessment and at least one follow-up biopsy.
Options For Dealing With Recurrence
With a persistently increasing PSA, the suspicion for recurrence increases. The most important factor in assessing your long-term outcome is determining the location of the prostate cancer cells producing the PSA. Advanced imaging techniques, such as MRI and PSMA PET/CT, are often helpful in learning where the cancer is located, and in the case of post-radiation recurrence, repeat biopsy may be required.
If a man underwent surgery as an initial treatment, revisiting the post-operative pathology report may help to identify what contributed to the recurrence. If there was still cancer present , the cancer was aggressive , or genomic profiling of the tumor showed high-risk features, several options are available:
- EBRT to the prostate bed with or without the pelvis.
- EBRT accompanied by hormone therapy. The duration of hormone therapy will depend on the PSA level just prior to radiation and to a lesser extent on the Gleason score and staging of the cancer.
- Systemic treatment using hormone therapy, other treatments for those at risk for metastatic disease, or a combination.
- Active surveillance if the remaining cancer appears insignificant. You and your doctor can decide whether to intervene more aggressively and, if so, when.
If you’re seeking additional or different approaches, you may be eligible to participate in an appropriate clinical trial . You can research this with the help of your doctor.
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Scared Stiff Of Having A Prostate Biopsy
Although the DRE and PSA tests are useful, they are not enough to make a clear diagnosis of prostate cancer. When results are abnormal or questionable, the doctor may prescribe a transrectal ultrasound and a biopsy. These examinations usually provide enough information for a precise diagnosis.
Having to undergo prostate biopsies can be scary: fear of the intervention, the pain it can cause, the unknown … or knowing you have prostate cancer. But remember, if you have cancer, the sooner it is diagnosed, the greater your chances of a complete cure with treatment!
Why a biopsy
Abnormalities detected during a digital rectal exam and a high PSA level often lead to a prostate biopsy. This procedure consists of taking small tissue samples of your prostate in order for the pathologist to examine them under a microscope to determine if they are cancerous or not.
That prostate biopsies are indicated does not mean that you necessarily have prostate cancer. Indeed, the analysis of microscopic specimens makes it possible to differentiate a benign hypertrophy from a cancer of the prostate.
To this day, the actual diagnosis of prostate cancer can only be made with a prostate biopsy.
Where Prostate Cancer Spreads
Many patients ask, can prostate cancer spread? The answer is, yes. Roughly 80 percent of the time 4 , when prostate cancer cells spread, they spread to bones 5 . Often, the cells spread to the hips, spine, and pelvic bones. This either happens as the cells travel through the blood or lymph nodes or direct invasion. When the cells relocate, they grow and form new tumors .
The good news is that for most men who are diagnosed with prostate cancer, its not terminal. Over 3.1 million men in America who have been diagnosed with prostate cancer are alive today.
Aside from skin cancer, prostate cancer is the most common cancer 6 in American men, with 1 of 9 men diagnosed in their lifetime. If caught early, there are a variety of treatments, including taking the holistic approach to prostate cancer.
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