Trans
Rectal Ultrasound (TRUS)
TRUS
is an examination where a finger-like probe is placed in the rectum, and
ultrasound pictures are made of the prostate. TRUS is an even more fuzzy test
than the PSA. It is very helpful in directing biopsies to areas of high
suspicion, but TRUS is non-diagnostic.
It may give information about prostate size, shape, and significant local spread
of prostate cancer, but it cannot make or deny the diagnosis of prostate cancer.
TRUS should never be done as an isolated test, but only when a biopsy is
to be done.
Needle
Biopsy of the Prostate
The
definitive test to make the diagnosis of prostate cancer is the needle biopsy.
A
thin needle, guided either by ultrasound or a finger, is inserted through the
rectum into the prostate, and a small sample of tissue taken. Usually 6 to
12 samples are taken from nodules, from suspicious areas seen on sonography, or
in a pattern sampling the entire prostate. This test has a better than 90%
accuracy in diagnosing prostate cancer, although occasional false negative
results occur when a small cancer in the gland is not sampled. The test, while
uncomfortable is frequently done without anesthesia.
Small amounts of bleeding in the urine, stool or semen are
common after biopsy. Significant bleeding, or major infection are
occasional complications of needle biopsy, rarely requiring hospitalization.
Preparation includes:
s stopping blood
thinners, (first check with the doctor who has you
on
this medication). Aspirin should be stopped at least 5 days before,
Plavix at least 7 days before, or if
that is contraindicated, a baby aspirin may be taken every other day for several
days before.
s Antibiotics
are frequently started the night before the procedure,
s A cleansing fleet
enema should be taken the morning of the test.
s If you are having
sedation you must not eat or drink after midnight the night before. You
may take all your medicines with a sip of water.
Biopsy results
will usually be available within a week. You should call your
urologist's office and make an appointment to see the doctor at least one week
after the biopsy. Most doctors do not give biopsy reports over the phone.
Occasional false negative results
are obtained so even if cancer is not found, follow-up
appointments with your urologist MUST be made and
kept.