Seven Important Questions
about Biopsy for Prostate Cancer

With the help of professionals, one of three types of biopsy for prostate cancer has been decided as best for your circumstances.  Now, it’s important to have the answers to these 7 questions before the booking is made:

   1.  Why do I need to take antibiotics before and after the procedure?
   2.  Should I stop or continue my current medications, especially blood thinners?
   3.  How many biopsy samples will be taken?
   4.  How long will it take and how long will I be at the medical facility?
   5   What does a prostate cancer biopsy feel like?
   6.  Should someone take me home?
   7.  Will there be prostate biopsy pain?

Do I need to take antibiotics before and after a prostate cancer biopsy?

Antibiotics will be prescribed to reduce the risk of infection from a number of causes, depending on the type of biopsy for prostate cancer you will have and your personal medical circumstances.  You may be asked to take them for days before the test and for at least 12 hours after.  Also ask about the need for pain medication afterwards.

Should I stop or continue my current medications?

Let your doctors know if you are taking blood thinners or urinary medications.  Blood thinners would usually be stopped a day before.

How many biopsy samples will be taken?

The number of biopsies taken will depend on what is necessary to take random samples from the whole prostate area.  This might depend on the likelihood that cancer is present based on family history, PSA level, what was felt as the texture and size of the prostate on rectal examination and whether this is your first or subsequent biopsy for prostate cancer. 

Six would not be considered enough, thirteen might be average but up to 20 could be taken.  When many more biopsy prostate samples are taken it is called ‘saturation’ biopsy.  The benefit of this is questionable, will be specific to circumstance and carried out under general anaesthetic.

How long will it take and how long will I be at the medical facility?

The whole process may take around 45 minutes.  The biopsies themselves are taken in seconds.  Local anaesthetic might make you feel groggy afterwards so factor this time into the day.  If you are having a general anaesthetic, say for a transperineal biopsy, then you may need to stay overnight if the procedure is booked after midday.

What does the prostate biopsy feel like?

Your worst enemy is your mind and your imagination, depending on the level of pain medication or anaesthesia. 

Be aware that if you have been given a local anaesthetic (you are awake but the treatment area is numb) you will hear the spring loaded biopsy gun go off each time sample of tissue is taken.  Distract yourself by talking to support staff.  It will be over soon. 

At transrectal biopsy there is pressure of the ultrasound probe on the prostate and possibly a sensation of needing to urinate when the urethra is compressed, so empty your bladder just before the procedure.

Should someone take me home?

If you know you are sensitive to local anaesthetic you might want someone with you.

If you are having a general anaesthetic the medical facility might not let you leave without someone to see you home safely.  This would be the case if you have had a transperineal biopsy for prostate cancer.  You should not be the one driving home and you will be uncomfortable sitting in the driving seat anyway

Will there be prostate biopsy pain?

Almost all men report no prostate biopsy pain during the procedure.  Remember that you will have anaesthetic, either local or general. See the heading above 'What does it feel like?'  If you tend to associate pain with an unusual feeling you might be merging the two experiences.as painful.

However, pain afterwards is likely for a day or two, once the effects of anaesthesia, local or general, wear off.  You will be given pain medications to prepare for this and should follow up with your local doctor.

Ask your urologist if he has had a biopsy himself?  If not, his understanding is what his tough male patients don't tell him.  Men don't disclose pain and what is felt afterwards doesn't seem necessary to talk about at a clinic appointment after the pain has gone. 

Have a conversation about pain medications, local and general anaesthesia until you have agreement as to how to manage your biopsy for prostate cancer.

Part 1 - Prostate biopsy

Part 2 - Seven important questions (this page)

Part 3 - One final question and decision time.

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