TRUS Biopsy - A New Technique? Can we do more? A single centre audit
Shaunna Smith, Hull University Teaching Hospitals NHS Trust
Background
Prostate cancer remains the second leading cause for death in men in the UK. Traditional Transrectal Ultrasound Guided Prostate Biopsy (TRUS Bx) has been found to miss as much as 50% of clinically significant prostate cancers. Clinically some patients with negative biopsies have been found with increasing PSA.
Traditionally, biopsies are taken from the left and right sides of the gland and the apex is not sampled. This results in around 30% of clinically significant cancers in the anterior gland being under-sampled. Sampling the anterior zone increases patient discomfort due to increased nervous supply at the anterior lobe.
Recently literature has focused on the use of prostate specific antigen density, as oppose to PSA alone. Men with PSAD >0.19 have an increased risk of clinically significant cancers. It is suggested that combining PSAd with an abnormal DRE may lead to improved detection if the TRUS Bx technique is adapted to include samples from the anterior aspect of the gland.