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In office procedure, with or without nitrous oxide.
A prostate biopsy involves first numbing the prostate with lidocaine and then taking small tissue samples from the prostate.
A prostate biopsy should NEVER be painful. Dr. Fronczak’s nerve block technique with lidocaine will numb the prostate to make your biopsy not painful.Plus, you can also elect to have nitrous oxide (laughing gas).
The prostate is visualized by placing an ultrasound probe gently into the rectum and visualizing the prostate with an ultrasound.
Antibiotics will need to be taken before the biopsy.
Blood thinning medications and antiplatelets must be held for the appropriate length before the prostate biopsy. Fronczak will provide you instructions. You may need the advice of your cardiologist or hematologist if you are uncertain about holding blood thinners or anti-platelets for your biopsy.
Fusion biopsies vs standard prostate biopsy
Often Dr. Fronczak recommends a multiparametric prostate MRI (link page on prostate MRI) as part of the evaluation for elevated PSA or abnormal prostate exam or to follow known low grade prostate cancer.
If the MRI shows a specific lesion of concern in the prostate, a fusion biopsy can be done.
A fusion biopsy involves superimposing a live transrectal ultrasound image of the prostate over the MRI image of the prostate. This technology allows focal biopsy of the lesion of concern.
Otherwise, a standard biopsy will involve 12 biopsies of the prostate, 6 on the left lobe, 6 of the right lobe. Standard biopsy with 12 cores has been shown in a multitude of studies to be the gold standard technique for finding prostate cancer with a biopsy.
Fusion biopsies are NOT a covered service by commercial or Medicare insurance and thus require an out of pocket expense to rent the fusion machine with a technician to run the machine.
Fronczak believes in using clinically proven technology to determine the need and timing to treat prostate cancer.
Prostate cancer risk can vary from low risk to intermediate risk to high to very high risk.
Some patients with intermediate risk, high/very high risk prostate cancers are eligible through insurance to have a special scan called a PSMA PET scan, the latest imaging to detect advanced disease.
Treatment options for localized prostate cancer can include robotic-assisted removal of the prostate (robotic assisted radical prostatectomy) or radiation. Other options may be available but at this time, Dr. Fronczak recommends treatments that are considered gold standard options but she can refer you to institutions where more treatment options may be available through clinical trials.