More not necessarily better when it comes to number of samples taken in a biopsy

NEW PROSTATE CANCER INFOLINK:  Is more better when it comes to the number of samples taken in a prostate biopsy? Not according to new research. READ MORE>

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Men need warning about biopsy side effects on urination and erectile function

URO TODAY: Men having a biopsy for prostate cancer need to be warned that it will temporarily affect urination and may also have an impact on erectile function, a German study says. READ MORE>

Prostate biopsy causes impaired voiding (of the bladder).

Saturation (20-core) prostate biopsy and periprostatic nerve block seem to have a lasting impact on voiding function.

Erectile function is transiently affected by prostate biopsy regardless of periprostatic nerve block and the number of cores.

Patients who undergo prostate biopsy must be informed about these side effects.

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Higher percentage of positive biopsy samples may mean prostate cancer has spread

URO TODAY: The greater number of positive samples in a prostate cancer biopsy (usually 12 samples), the greater the chance the disease has spread to the lymph system. READ MORE>

The percentage of positive cores involved with prostate cancer is the most reliable predictor of lymph node metastases and indicates the need for extended pelvic lymphadenectomy.

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Combo MRI and needle biopsy may help locate prostate tumours more accurately

URO TODAY: Knowing exactly where in the prostate a biopsy sample has come from is a problem for those diagnosing the disease, but scientists may have found a way to improve that by combining MRI scans with needle biopsy. READ MORE>

It is feasible to document the location of transrectal ultrasonography (TRUS)-guided prostate biopsies on pre-procedure MRI by fusing the pre-procedure TRUS to an endorectal coil MRI using electromagnetic needle tracking.

This procedure may be useful in documenting the location of prior biopsies, improving quality control and thereby avoiding under-sampling of the prostate, as well as directing subsequent biopsies to regions of the prostate not previously sampled.

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5-Alpha reductase inhibitors may increase accuracy of PSA tests

URO TODAY: 5-Alpha reductase inhibitors, such as finasteride and dutasteride, may increase the accuracy of PSA tests in men with elevated or fluctuating PSA levels and previous negative biopsy, according to new data from researchers. READ MORE>

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New questions raised over accuracy of prostate cancer biopsy analysis

URO TODAY: Use of a scale (the T Scale) to rank the seriousness of prostate cancer and thus guide doctors on treatment options has been called into question by new US research. READ MORE>

Analysis of biopsy samples taken from the prostate is not always accurate in determining how far a tumour has spread, a research team says in a paper to the American Urological Association (AUA) annual meeting.

Those with a T2a score have cancer that is confined within the gland and on one side (lobe) only, making them candidates for nerve-sparing surgery and other focal therapy.

“This data suggests that selection of patients who truly have pT2a disease is extremely difficult and may impact [on]successful application of focal therapies,” the researchers say.

The T scale is applied to cancer confined to the prostate and surrounding areas:

Clinical
TX — Primary tumor cannot be assessed
T0 — No evidence of primary tumor
T1 — Cannot detect tumor with imaging tests
T1a — Less than 5 percent of the prostate is affected by the tumor
T1b — More than 5 percent of the prostate is affected by the tumor
T1c — Tumor identified by needle biopsy, PSA elevated
T2 — Tumor confined within prostate
T2a — Tumor affects one-half of one lobe or less
T2b — Tumor affects more than one-half of one lobe but not both lobes
T2c — Tumor affects both lobes
T3 — Tumor extends through the prostate capsule
T3a — Tumor extends beyond the prostate capsule
T3b — Tumor invades seminal vesicle(s)
T4 — Tumor is fixed or invades surrounding areas, such as the bladder neck, external sphincter, rectum, levator muscles, and/or pelvic wall

Pathologic
pT2 — Tumor confined to the prostate
pT2a — Tumor affects one-half of one lobe or less
pT2b — Tumor affects more than one-half of one lobe but not both lobes
pT2c — Tumor affects both lobes
pT3 — Tumor extends beyond the prostate
pT3a — Tumor extends beyond the prostate
pT3b — Tumor invades seminal vesicle(s)
pT4 — Tumor invades the bladder, rectum

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Proportion of positive biopsy samples may be indicator of later success of hormone therapy for prostate cancer

URO TODAY: The number of positive core samples in a biopsy for prostate cancer appears to be related to how successful hormone therapy will be later. READ MORE>

Our study of 403 patients with an overall mean follow-up of five years supports the concept of a significant association between the proportion of positive biopsy cores and the prognosis of prostate cancer treated by hormonal therapy.

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