Biopsy - Prostate

This procedure involves the removal of a sample of prostate tissue to check for the presence of abnormal, or cancerous, cells.

This procedure involves the removal of a sample of prostate tissue to check for the presence of abnormal, or cancerous, cells.

Prostate cancer refers to the growth of abnormal (malignant or cancerous) cells in the prostate gland. The prostate gland is part of the male reproductive system. Along with other smaller glands, it produces fluid (also known as semen) that carries sperm and provides them with nutrition.

  • The prostate gland is located at the base of a man's bladder. It surrounds the tube through which urine is drained to the outside of the body. It also carries semen that is released during sexual relations.
  • The prostate is normally the size of a walnut. The size usually increases with age. Assuming cancer is not present, this enlargement is called benign prostatic hyperplasia (BPH). Infections or tumors can also increase the size of the prostate.
  • Because of its location, an enlarged prostate can block the flow of urine from the bladder through the urethra.
  • The back section of the gland is located next to the rectum. Cancer most often develops in this section.
  • Nerves that control erectile function are located on both sides of the gland. These nerves can be damaged by some prostate cancer treatments.

A prostate biopsy is the removal of a sample of prostate tissue to check for the presence of cancer. It is needed to determine if enlargement of a prostate is due to cancer or BPH.

  • BPH does not increase a man's risk for prostate cancer.
  • Prostate specific antigen (PSA) is a blood test that can be used to monitor the prostate.
  • Although it may be used to screen for prostate cancer, PSA levels can be elevated for reasons other than prostate cancer. These reasons include BPH, a recent prostate exam, infection or sexual intercourse.

Your healthcare provider may recommend a prostate biopsy to check for prostate cancer if you have:

  • An abnormal digital rectal exam
  • An elevated prostate specific antigen (PSA) blood level
  • Symptoms consistent with prostate cancer

A biopsy of the prostate is usually done in a healthcare provider's office. If needed, you may be given some medication to help you relax.

  • A special ultrasound probe is usually inserted into the rectum to transmit images of the prostate. It also helps determine where to put the needle for the biopsy.
  • Multiple biopsies are often performed at the same time. Multiple biopsies improve the accuracy of a diagnosis, but they also increase the risk of infection.

Many factors increase a man's chance of prostate cancer. Risk factors for prostate cancer include:

  • Age – You are over 65.
  • Family history – Your father or brother has a history of prostate cancer.
  • Race – You are African-American.
  • Alcohol use – You drink an excessive amount of alcohol.
  • Agent Orange and cadmium – You were exposed to Agent Orange or cadmium.
  • Diet – Your diet is high in fat, especially animal fat.
  • Occupation – You are a farmer, tire plant worker or painter.

It is important to note that having risk factors for prostate cancer does not mean you are sure to develop it. In fact, other than age, most men with prostate cancer have no identifiable risk factors.

  • Eating a diet that is vegetarian, or low in fat and high in omega-3 fatty acids, can help decrease your risk of developing prostate cancer.
  • Studies have shown no increased risk for prostate cancer after a vasectomy.

Prostate cancer is often a very slow-growing cancer. Very small prostate cancers may not cause any symptoms. However, the treatments for prostate cancer (such as surgery or radiation) can have significant unwanted side effects. Some of the symptoms that can be seen in the early stages of prostate cancer can also be caused by other non-cancerous prostate problems. These symptoms include:

  • Difficulty stopping or starting urination
  • A urine flow that is slower than normal
  • Leaking of urine, especially after urinating
  • Having to strain to push urine out
  • Difficulty emptying the bladder
  • Bloody urine or semen
  • More frequent urination with increased urination at night
  • Urgent need to urinate
  • Inability to urinate
  • Painful or burning urination
  • Painful ejaculation
  • Erectile dysfunction (difficulty having or sustaining an erection)

As the cancer advances, swelling in the lower legs and pain in the bones can develop. This pain is typically in the lower back and hip area.

Contact your healthcare provider if you have any of the above symptoms. Your healthcare provider will perform a physical exam of your prostate (digital rectal exam) and may order a PSA level or biopsy.

  • Discuss the pros and cons of having screening digital rectal exams (DRE) and PSA testing with your healthcare provider.
  • In some cases, a bone scan and CT scan may be ordered to see if there are signs of cancer in the other organs.

If your healthcare provider recommends a prostate biopsy, prior to the procedure tell him or her about any medications you are taking (including over-the-counter medications and supplements). You should also ask about specific instructions to follow before and after the procedure. These include:

  • Medications you should not take before the procedure, such as blood thinners
  • Regular medications you should continue to take on the day of your procedure
  • How many hours you should stop eating and drinking before the procedure

You should contact your healthcare provider if you have symptoms of prostate cancer or want to discuss the pros and cons of prostate cancer screening. Be prepared to discuss any symptoms you have and how long you have had them.

  • Bring a copy of your medical history (past illnesses, surgeries, and hospitalizations).
  • Make a list of your medications (including over-the-counter).
  • Write down any questions, symptoms or concerns you want to talk about.
  • If your healthcare provider prescribes a medication for you, ask for a generic version. If your doctor thinks that a generic version is not right for you, ask for a medication on the lowest available tier of your Prescription Drug List (PDL).

What should I ask my healthcare provider before having a prostate biopsy?

  • What is my diagnosis and reason for the surgery? Are there any alternatives? What are the benefits and risks of each?
  • What are the possible complications for this surgery?
  • What happens if I do not go through with the surgery?
  • What is your experience in doing this type of surgery? What is your complication rate?
  • Will I need anesthesia? What are the possible side effects?
  • How will I feel after the surgery? Will I have to modify my activity?
  • How long do to I have to avoid sexual intercourse?

After your surgery, you should know what you had done, what medication was given, and what symptoms you should report to your healthcare provider after discharge. You should also understand all home care instructions (including medications and side effects) and follow-up plans. Your surgeon should also communicate with your primary care physician.


Also known as:

Prostate Biopsy
Needle Biopsy
Biopsy - Prostate
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