Chapter 8 - Staging of Prostate Cancer, PSA Issues Leading up to Prostate Biopsy and Biopsy Technique

Abstract

This chapter outlines certain issues faced by the clinical urologists while assisting in making treatment decisions. Specifically, it discusses the role of staging in both clinical and pathologic prostate adenocarcinoma, evaluates the utility of prostate specific antigen (PSA) assessment, and discusses the variations on prostatic biopsy techniques and methods. The decisions each urologist makes regarding the management of prostate cancer are extremely complex. Proper consideration of patient quality of life issues and potential treatment outcomes is mandatory. Successful cancer prevention strategies can be developed with proper understanding of the disease etiology and contributing factors associated with its pathogenesis. PSA testing, in combination with annual digital rectal examination, is essential for early prostate cancer detection. The goal of cancer staging is to assess the extent of disease as precisely as possible. Serum PSA and many modern imaging modalities are currently available to gather information that ultimately help to guide management options. Transrectal ultrasound of the prostate (TRUS)-guided biopsy is the mainstay for achieving a histologic diagnosis of prostate cancer. An optimal protocol for the detection of prostate cancer with transrectal ultrasound-guided biopsy has yet to be determined.