Needle biopsy During the rectal examination, if a lump or any kind of hardening is found on your prostate, the doctor takes a sample of the cells for further examination through a microscope. The biopsy can also be done through the skin behind the testicles, but the most common way is through the rectum using the Trans rectal ultrasound scanner. Biopsy can be done even to the out patients. The patient has to be explained to what is to be done to him, so that he is not met by surprise. He is also given antibiotics before the biopsy to stop any infection to spread after the examination.
The antibiotics can be taken by injection directly in to the vein, through the mouth or through the rectum in a suppository. Another PSA test may be run to ensure that the readings really indicate any cancer symptoms. In order to have the biopsy, the patient lies down on the left side. The doctor then inserts the rectal ultrasound probe in to the back passage to examine prostate. The needle is then put into the prostate and in to the ultrasound probe to get a sample of the prostate tissue.
This may feel a little painful and uncomfortable, but anesthetics are used to make the area numb so that the examination is painless. The patients are advised to drink a lot after the examination. Effects of the examination may be bleeding from the prostate and urine infection. That is why the patients are advised to drink a lot to prevent the infection from spreading by flushing the blood. There may also be blood in the urine and the semen but only for a few weeks after the examination. However, in case of an infection, the patient should consult the doctor as soon as possible.
The signs and symptoms of the infection may include high temperatures, shaking or shivering, presence of a lot of blood in the urine or irregular urination. Urine test, (PCA3) PCA3 stands for Prostate CAncer gene 3. This test is new to the doctors to help them determine patients with prostate cancer and who should have biopsy. PCA3 genes are found in the cancer cells, and they ensure the cells produce a certain type of protein. The PCA3 protein leaks in to urine if it is high, thus making it possible for it to be measured by a urine test. This test may be the most commonly used in the future.
(Godoy G, Sankin A, et al. 2009) Advanced practice management It is important to treat the prostate cancer as early as it is detected. Deciding on the treatment of the prostate cancer is dependant on various factors. These include; a) How far the cancer has spread and grown. It is important for the doctor to know the stage of the tumor so that he can know the treatment to use on the patient. A cancer that has been detected at a very early stage will not be treated the same as the one at an advanced stage. b) How the cancer cells of the patient look when viewed under a microscope.
If the cancerous cells of a patient are similar to the normal prostate cells, then the cancer will be said to be at a lower grade. However, if the cells seem abnormal, then the cancer is a high grade cancer. A low grade cancer grows and develops slowly than the high grade cancer. c) The patient’s Gleason score. A Gleason score is important in describing the grade of the cancer. After a biopsy is performed, each area that shows the cancer cells is classified from 1 to 5, depending on the look of the cells. Those closer to 1 are more normal compared to those closer to 5.
The doctor identifies the two areas with the highest grades, adds the scores to get the Gleason score. The grade is used to determine the behavior of a cancer. d) The age and the general health of the person. The age factor is considered because some prostate cancer cells grow very slowly. A patient, who is old, has the cancerous cells and does not show the cancer symptoms may live long without the aid of the treatment. In other patients, the cancer may be growing slowly, such that even if the patient is old, his life expectancy is high.
Some of the patients whose cancer cells grow slowly are advised to wait and se what happens, instead of experiencing the side effects of the treatment. e) The PSA blood test. This test is important because it shows the speed at which the cancer is growing. It helps to determine the progress of the cancer. f) The patient’s choice and decision about the treatment. The patient in most cases determines which treatment will be used on him. The method of treatment chosen should be beneficial, affordable, and the side effects that the patient can be able to deal with. (Thomadaki H 2009, pages 373-80)