Harvard Men's Health Watch

Prostate biopsy: What to expect

Here are the benefits, risks, and uncertainties of the only diagnostic procedure that can tell you whether you have prostate cancer.

Prostate cancer screening with the PSA test intends to uncover cancer before symptoms develop. At this early stage, treatment might be more effective—although this has been difficult to prove. But the results of a PSA test are never certain: An elevated value does not confirm the presence of cancer—only that cancer may be present—because other things besides cancer can affect the test results (see "Your PSA test result," Harvard Men's Health Watch, December 2012).

Only a prostate biopsy can confirm the actual presence of cancer. That requires removing snippets of tissue from the prostate with a needle and checking them for cancerous cells under the microscope. Biopsy, however routine it may seem, is still an invasive procedure with risks. The biopsy needle passes through the rectal wall to get to the prostate, which can spread bacteria or an infection to the prostate gland or bloodstream. Additional risks include pain and erectile or urinary problems.

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