Just for Men: Prostate Cancer Can Be Diagnosed Without Blind Biopsies
Channel: BioBalance Healthcast
Date: 2023-11-13

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This subject is for men who have had a high PSA and who have been advised that they need a prostate biopsy to determine if they have cancer. Many men go into the doctor for the biopsy necessary for diagnosis without expecting the “blind biopsy” procedure that is done through the rectum and is extremely painful when the doctor blindly takes pieces of the prostate…over and over again.   Blindly, means he is randomly picking a place to biopsy without a real target….with the urologist biopsying everywhere in the prostate 10 or more times. Finding a small cancer with this random or “blind” biopsy method is a less than effective way to find a small area of prostate cancer. Men who have had this procedure done rarely agree to a second round, under any circumstances and I agree with them.
I always do a PSA test before I treat a man with testosterone so I often am faced with the question of what advice I should give him in this situation before I feel it is safe to give him testosterone. Of course, if he has prostate cancer, even a high PSA, I will not give a man testosterone until his urologist says he is safe to receive it. 
 Until recently there was no radiologic way to screen a for prostate cancer. Now urologists use Ultrasound or MRIs to find an abnormality in the prostate that they can biopsy.  This makes the procedure both more accurate and less painful.
The way this procedure was done in the past, and is still done throughout the US, always caused me to wonder why urologists hadn’t figured out a way to do it in a way that accurately biopsied a high-risk area of the prostate, with one or two biopsies.  Now Urologists use rectal ultrasound or MRI, like Gynecologists use vaginal ultrasounds to find and drain or biopsy ovarian masses, or to harvest eggs in IVF. The urologists have even borrowed the idea to use numbing medicine as well to make it comfortable.  In the last 2 years I have found a few Urologists who have embraced the new, accurate biopsy procedure that used the MRI to find high risk areas and ultrasound to locate suspicious areas for biopsy, then used the same radiologic method to locate and treat discrete focal areas of abnormality with cryotherapy (freezing) or focused ultrasound.  
Finally in August of 2023, a research article titled, “Focal Therapy for Localized Prostate Cancer in Older Men”, was published in the Journal of Urology. 
This article describes a much more accurate method of treating prostate cancer that resulted in the diagnosis and treatment of low-grade prostate cancer without recurrence and without complications, allowing men to have a conservative treatment for low grade prostate cancer, following a less painful and invasive diagnostic procedure. Compassion has finally come to diagnosis and treatment of prostate cancer. We applaud the authors.