There are around One Million prostate cancer biopsies performed each year in the USA. Many of these, as much as 75%, will be negative for cancer. The process is reasonably, to minimally painful. It is usually performed as an outpatient procedure. What doctors don’t often tell you is that cancer cells can be missed even when the biopsy is guided with trans-rectal ultrasound; that up to 4% of men who have a biopsy need hospitalization for infections that are resistant to antibiotics; and even a single biopsy may over time spread cancer outside the prostate, increasing the need for more drastic treatment. As one senior oncologist put it, the biopsy process creates wounds in the prostate. These are along the paths where needles are inserted to obtain tissues for testing. To heal that wound the body brings in growth hormone causing cells to grow faster. Prostate cancer loves growth hormone and when a biopsy needle punctures a cancer cluster, the cancer cells will grow out along the path of the wound (like little pacmen gobbling the growth hormone) until they eventually escape from the prostate. The cancer then starts circulating within the body looking for another place to attach and grow.
While a prostate biopsy does define the presence and severity of any cancer it finds and may never be completely eliminated, the issue becomes what of the approximate 75% of men where cancer is not found. Are these 750,000 biopsies putting men to unnecessary risk? What about the prostate cancers the biopsy needles miss? Are these men missing a chance to take early steps that might help their bodies to fend off an initial cancer attack, or be more easily cured? Fortunately there are a few new tests promising better reliability, and a safer process. Unfortunately some of these are so new that they are not yet covered by insurance. They include the ONCOblot Test looking for the ENOX2 protein, the MiPS Test looking for a specific gene fusion in urine to define the probability of prostate cancer, and better MRI/ultrasound imaging. Just click on these links, or go Prostate Screening Tests at the top of this page to find out more.