A biopsy is a short procedure during which a doctor takes a small sample of cells from the prostate. A pathologist examines the tissue sample under a microscope and determines whether the cells are normal or cancerous.
We use the least invasive biopsy procedure possible, minimizing discomfort while still obtaining enough cells to make a diagnosis.
We specialize in image-guided biopsy, which uses one of our imaging technologies to precisely locate the area where we need to take the tissue sample. We offer several types of prostate biopsy, and you may need one or more types depending on your individual case.
- Image-guided biopsy: Our radiologists often use imaging to precisely locate the abnormal tissue and guide the needle for the sample.
- Core biopsy uses a thin, hollow needle to take the sample. Your doctor will give you a local anesthetic and then insert the needle through the wall of your rectum to reach the prostate. This is the biopsy procedure we use most often to confirm a diagnosis of prostate cancer.
While the overall procedure lasts about 10 minutes, the actual biopsy lasts only a fraction of a second.
You will be prescribed antibiotics before the procedure to control any risk of infection. You may feel some soreness for a few days and notice blood in your urine and from your rectum. You may also notice blood in your semen for up to several weeks.
Pathology: Analyzing prostate biopsies
After you have a biopsy, your nurse sends your tissue samples to our pathologists for review. A pathologist is a medical doctor who specializes in reviewing and evaluating lab tests, cells, and tissues to diagnose disease. Our pathologists analyze biopsy samples to determine whether the tissue is cancerous and, if so, what type of prostate cancer it is.
At the Stanford Prostate Cancer Program, our pathologists specialize in prostate cancer. That focus means they have extensive expertise interpreting prostate biopsies and other tests to confirm or rule out a prostate cancer diagnosis.
Because prostate cancer represents a complex group of different diseases, it’s important to have expert pathologists on your care team. Years of experience studying prostate cancer every day means your pathologist can accurately identify critical details. This information includes whether the cancer:
- Is invasive or noninvasive
- Shows a high or low cell grade or Gleason score (rating that describes how different the cancer cells are from normal cells)
- Is aggressive or slow growing
- Contains molecules that indicate the cancer subtype
All these details help form an accurate diagnosis, which is vital to your treatment plan. Your care team takes the time to do a thorough evaluation from the start, so that your treatment will be more effective.
Biopsies can still sometimes miss a cancer if none of the biopsy needles pass through cancer cells. If your other imaging and blood test result prompt your doctor to suspect you have prostate cancer, a repeat biopsy may be recommended to help be sure.
Prostate tumor tissue bank
Our doctors and researchers work to thoroughly understand the true diversity of prostate cancer and identify the genetic abnormalities that can play a role in prostate cancer formation. That’s why it’s critical that our doctors have access to tissue samples to plan for each patient’s care.
At Stanford, we store prostate tissue samples so we can use them for research, using the following process:
- After we take a biopsy (tiny sample of prostate tissue), we ask you if you would like to give it to the tissue bank.
- The tissue first goes to the laboratory, where the pathologist samples it.
- If you approve, the tissue then goes to prostate cancer research specialists. These doctors work with our clinicians (doctors involved in patient care) to identify new pathways of tumor formation and possible treatments.
Our prostate tumor bank provides our doctors and other researchers with a variety of different types of prostate cancer cells to study. As we work on new methods and tools for diagnosing and treating prostate cancer, our goal is to move these findings from the lab into patient care.