A prostate biopsy involves taking small pieces of prostate tissue to be looked at under the microscope. You will usually have a biopsy called a trans-rectal ultrasound (TRUS) guided prostate biopsy.
A high PSA level alone doesn't automatically mean that you need a biopsy. Your doctor should talk to you about the pros and cons of having a biopsy, and discuss any concerns you may have before you decide whether to have it.
You might not need a biopsy if other tests, such as a bone scan, shows the cancer has spread outside the prostate.
What are the pros and cons of a TRUS biopsy?
- A biopsy is the most accurate way of finding out if you have prostate cancer and how likely it is to spread.
- This can help you and your doctor or nurse decide which treatment options may be suitable for you.
- A biopsy can pick up a faster growing cancer at an early stage – when treatment might prevent it spreading.
- The biopsy can only show if there was cancer in the samples taken. If your biopsy result is normal it can’t rule out cancer completely – the biopsy takes tissue from small areas of the prostate, so it might miss some cancer.
- A biopsy can pick up a slow growing cancer that might not cause any symptoms or problems in your lifetime.
- A biopsy can also have side effects.
A TRUS biopsy involves using thin needles to take around 10 to 12 small pieces of tissue from the prostate.
Before the biopsy you should tell your doctor or nurse if you’re taking any medicines, particularly drugs that thin the blood.
The biopsy is done through the back passage (rectum). You'll have a local anaesthetic injection into your back passage to ease any discomfort.
Your doctor or nurse will put an ultrasound probe into your back passage, using gel to make it more comfortable. The ultrasound probe scans the prostate and an image appears on a screen. A needle is then inserted through the wall of the back passage into the prostate - using the ultrasound image as a guide.
The biopsy will take 10 to 15 minutes. You might have to wait until you’ve had a pee (passed urine) before going home. You’ll be given antibiotics to help prevent infection. You will also be given antibiotics to take at home – it’s important to follow the instructions and take all of them.
Some men find the biopsy painful, but others have only slight discomfort. If you have any pain, tell your nurse or doctor. You may need mild pain-relieving drugs, such as paracetamol.
If you’re gay or bisexual you might need to be careful when you have sex. If you have anal sex, you should ideally wait around six weeks after a biopsy before you receive anal sex. Ask your doctor or nurse at the hospital for further advice.
What are the side effects of TRUS biopsy?
- You might see a small amount of blood in your urine or stools for two weeks or in your semen for a couple of months. If it takes longer to clear up, or gets worse, see a doctor straight away.
- Up to 3 in 50 men (6 per cent) may get a more serious infection.
- A fever (high temperature), chills, pain or burning when you pee, or difficulty in peeing are signs of an infection. This can happen even if you’ve been taking antibiotics. If you have these symptoms go to your nearest accident and emergency (A&E) department straight away.
- A small number of men can’t pee after a biopsy (urine retention). If this happens contact your doctor or nurse at the hospital straight away, or go to the A&E department.
- Some men have discomfort or pain for a few days or weeks afterwards. Speak to your doctor or nurse about pain relief.
- There’s a small chance of getting a urine infection after the biopsy. Take the antibiotics your doctor gave you.