Biopsies are a regular part of the screening and monitoring process for prostate cancer. Throughout their journey with prostate cancer, many men may need multiple biopsies. Whether for active surveillance monitoring or a general follow-up procedure to test for spread of cancer, additional biopsies may be part of your treatment plan.
Given the unwelcome side effects that often come with treatment, many men question whether repeat biopies will also cause unwelcome side effects. Research has shown that men who had multiple biopsies prior to radical prostatectomy do not experience longer-term recovery compared to men who had only a single biopsy, but what about side effects?
Understanding treatment decisions
Treatment decisions can be complicated for men confronting a prostate cancer diagnosis. Many of the treatment options for prostate cancer can cause unwelcome side effects that negatively impact your life. Understanding the short-term and long-term side effects of each option can help in making a confident treatment decision.
There are several factors to take into consideration when deciding what treatment option works best for you. Men with slow-growing, localized prostate cancer often choose to engage in watchful waiting or active surveillance rather than risk the side effects of treatment or surgery for uncertain benefit.
Some men choose surgery to treat localized prostate cancer that has not spread outside of the prostate gland. The most common kind of prostate surgery is called a radical prostatectomy, and it involves removing the entire prostate gland plus some of the tissue around it.1,2
Prostate surgery can have unpleasant side effects for some, including:
Given the choice, many men prefer to put off surgery and rely on active surveillance and less invasive monitoring for as long as possible. Some early studies of men who would qualify for active surveillance show that two-thirds never need to pursue further treatment with surgery or radiation.3 But this can mean needing multiple biopsies during the course of surveillance.
Good news looking forward
Research is giving way to good news for those choosing active surveillance to manage their prostate cancer, especially for those who also need multiple biopsies. For men who undergo surgery after biopsies, there is no reported increase in erectile dysfunction or urinary incontinence for those who had multiple biopsies compared to just one biopsy.4
Given the popularity of active surveillance for early prostate cancer treatment, there is a growing number of men who will eventually require surgery after multiple biopsies.4 The good news coming from research indicates that men can hold off on surgery for longer without increasing their risk of unpleasant side effects.
Surgery for Prostate Cancer. American Cancer Society. https://www.cancer.org/cancer/prostate-cancer/treating/surgery.html. Published November 20, 2017. Accessed February 7, 2018.
Prostatectomy. Mayo Clinic. https://www.mayoclinic.org/tests-procedures/prostatectomy/about/pac-20385198. Published December 29, 2017. Accessed February 7, 2018.
Watchful Waiting or Active Surveillance for Prostate Cancer. American Cancer Society. https://www.cancer.org/cancer/prostate-cancer/treating/watchful-waiting.html. Published March 11, 2016. Accessed February 7, 2018.
Natasha Persaud, Repeat Prostate Biopsies Do Not Raise Risk of Post-RP Complications. Renal & Urology News. http://www.renalandurologynews.com/prostate-cancer/prostate-cancer-multiple-biopsies-do-not-increase-ed-urinary-incontinence/article/719849/. Published December 20, 2017. Accessed February 7, 2018.