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STPB Improves Active Surveillance of Prostate Cancer

Pt jeans,white button shirt w doc in lab coat

In a recent blog , we described the practice of Active Surveillance of Prostate Cancer and CPCC’s guidelines for patients who choose to safely monitor their early stage prostate cancer rather than seek active treatment.  One key recommendation is to receive periodic biopsies, or tissue sampling, of the prostate in order to watch for tumor growth.  CPCC highly recommends men maximize the diagnostic information available from each biopsy session by undergoing a biopsy technique called Stereotactic Transperineal Prostate Biopsy (or STPB).

What is Stereotactic Transperineal Prostate Biopsy?

Most prostate cancer diagnoses are based upon a standard transrectal biopsy administered in the office by a urologist.  Yet this transrectal approach permits only random needle sampling of the prostate.  Furthermore, transrectal samples are taken at an angle that misses the lowest region of the prostate gland  (the anterior-apex area) where “hidden prostate tumors” are often located.

To better locate all tumors, Chicago Prostate Cancer Center pioneered Stereotactic Transperineal Prostate Biopsy, or STPB.

How would STPB benefit me?

STPB provides the proper angle to allow the physician to take biopsy samples that reach the entire prostate gland, without missing the apex area.   Our published research demonstrates that as many as 40% of patients originally thought not to have malignancy, indeed had hidden tumors that would otherwise have gone undetected.

Mapping improves treatment

STPB’s grid-like template allows tissue locations to be mapped as they are sampled.  This is useful information for later treating sites that may be determined cancerous.  STPB is a convenient out-patient procedure that is virtually pain-free since it is completed using general anesthesia.

Avoiding false negative biopsies

Originally, our experience using STPB was confined primarily to patients who were diagnostic dilemmas:  men who had persistent elevation of PSA level, but whose repeat transrectal biopsies continued to be negative for cancer.  Now, STPB is more and more commonly being requested by patients as their initial biopsy technique.  Patients who elect a specific treatment option (including brachytherapy) — instead of going the Active Surveillance route— also benefit from STPB’s reassurance.

Virtually eliminates risk of infection

In contrast to the transrectal approach (where a biopsy needle passes through the contaminated rectal wall), the transperineal approach (through the skin between the scrotum and the rectum) virtually eliminates the risk of infection.  Read one man’s struggle with infection.

Watch for our next blog that shares how STPB further advances the diagnostic power of biopsy when coupled with Genomic Testing.

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