Your 50/50 shot of missing prostate cancer with initial biopsy

More than one million biopsies for prostate cancer are performed annually in the U.S., with 40%-50% of initial biopsies identifying cancer.  So more than one half million new cases have negative prostate biopsies.

Yet ... in those who have repeat biopsies because of rising PSAs, cancer is identified in approximately 25% of these men.

In other words, our current biopsy procedure "misses up to half of all small tumors and up to one third of tumors eventually detected even using repeat sextant biopsy," according urologist Dr. J. Stephen Jones, in his article Managing Patients Following a Negative Prostate Biopsy, in Renal and Urology News, Feb. 8, 2011. (Graphic at right from article)

Yeah, that's scary -- there's a lot of missed cancer, but also a lot of unnecessary biopsies.

Anyone who has had a prostate biopsy would prefer NEVER to repeat that experience. Unfortunately, repeat biopsies for prostate cancer are commonplace; half are important, half unnecessary.  All biopsies are not only an uncomfortable-at-best experience, but they are attended by "low but real hazards," 
writes Dr. Jones.

What kind of hazards? Some physicians says biopsies can contribute to spreading cancer. That's the worst case, though Dr. Jones says the risk is very low.

It's incredible the screening for prostate cancer isn't better than it is.  MRI screens supposedly are getting more accurate, and there are new screens in development that may eliminate a significant percentage of unnecessary biopsies. But at present, biopsies -- the only way we have to definitively determine the presence of cancer -- is still a guessing game.

Think about it:  You may have microbits of cancer in your prostate, and a biopsy goes in an strategically snips maybe 12 little chunks to try and find cancer.  It's easy miss -- and apparently it does, about half the time.

Diagnosis for prostate cancer needs to get to the point where a negative results means negative, not a "50% chance that it's negative, 50% chance it isn't." 

My PSA is rising again, and if it rises for a third time next month, I'll want antibiotics for 4-6 weeks to eliminate any chance of infection before submitting to another biopsy.