What to Expect During Your Prostate Cancer Biopsy

Knowing what to expect may help alleviate some of your concerns

Senior man sitting on armchair drinking glass of water
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If your doctor suspects you have prostate cancer, they will need to perform a prostate biopsy in order to definitively diagnose whether or not you have prostate cancer. Sometimes this procedure can be a source of anxiety and concern. Knowing what to expect may help alleviate some of your concerns.

Before the Biopsy

Before going in for your biopsy let your doctor know about any major medical conditions that you have. If you have heart or lung disease, make sure to let your doctor know ahead of time. 

You should also give your doctor a full list of any medications you may be taking, especially any blood thinners you may be on. Coumadin (warfarin), Plavix (clopidogrel), aspirin, and heparin are a few common blood thinners your doctor should be made aware of. Your physician will likely have you stop taking these prior to the procedure to minimize your risk of bleeding.

The Day of the Procedure

Your physician will likely instruct you to use an enema either at home or at the office a few hours before the procedure. While unpleasant, it is important you don't skip this part of your preparation. The enema will make the biopsy easier to perform and may lessen your chances of an infection.

You should only drink clear liquids the morning of the procedure. Additionally, many physicians instruct their patients drink a large amount of water in the hours before the procedure. A full bladder can make it easier for your doctor to visualize your prostate and surrounding structures on ultrasound.

In addition to your regular medications, most physicians will prescribe a short course of antibiotics to be started the night before or the morning of your biopsy.

During the Procedure

Once you get into the procedure room, your doctor will instruct you to lay on your side (usually your left side) with your knees pulled up. Some local anesthetic (numbing medicine) will be injected into your skin around where the biopsy needles will be placed. A thin ultrasound probe will be placed into your rectum in order to obtain an image of the prostate and surrounding structures. This will be left in place during the procedure.

The biopsy specimens are then taken by inserting very thin, hollow needles into the prostate. Twelve samples from various areas of the prostate will be taken to be sure that the whole prostate is checked for cancer. It is normal to have some pain and discomfort as the biopsies are being taken, despite the numbing medication. From start to finish, the whole procedure usually lasts roughly 20 minutes.

After the Procedure

Once the procedure is over, the biopsy samples will be sent to a laboratory where a pathologist will determine if cancer or another condition is present. Your physician will give you specific instructions about what you need to do after your procedure, but usually they will instruct you to resume eating normal foods, continue the course of antibiotics they prescribed, drink extra water to further clean out your urinary system, and to continue to not taking any blood thinners you were told to stop prior to the procedure, at least for a few days following the procedure.

Some men have rectal soreness for a few days. This can be alleviated with warm soaks or compresses to the area. Some men experience light bleeding or spots of blood in their stool, urine, or semen. If the amount of bleeding is small and it stops after a few days, this is considered normal