40% of Men Who Test Negative for Prostate Cancer May Have It

Forty percent of men with prostate cancer may be unaware that they have it, according to research conducted by the Prostate Cancer Foundation in Chicago. The study found that the standard office biopsy procedure is often inadequate for proper detection of the disease.


During the four year study, researchers studied 747 patients with elevated prostate specific antigen (PSA) levels. All patients had been tested using transrectal prostate biopsies at least once and all results were negative. Then researchers utilized an advanced biopsy technique called stereotactic transperineal prostate biopsy (STPB). The biopsy results identified the presence of cancer in 291 (395) of the patients.

Director of the Prostate Cancer Foundation, Michelle Bacioforte, claims, “Men who have negative transrectal biopsies and continue to have elevated PSA levels should consider STPB because 40% will harbor malignancy. Our level of confidence is greatly enhanced with regards to the presence or absence of cancer, and more specifically, the exact location of the cancer within the prostate.”

Stereotactic  transperineal prostate biopsy is performed by taking a median of 40 samples of the prostate through the perineum while the patient is sedated under general anesthesia. The outpatient procedure allows for more comprehensive sampling of tissue, compared to the standard transrectal method, which takes fewer samples through the rectum. Additionally, extracting samples during STPB allows researchers to pinpoint the exact location of the cancer.

One in six men in the U.S. will be diagnosed with prostate cancer, the most common form of cancer among men.  For those who find themselves with elevated or rising PSA levels, this is a sign that further testing should be administered to rule out prostate cancer.  

"The information obtained from this kind of comprehensive biopsy allows us to design and perform more sophisticated treatment plans", says Dr. Brian Moran, medical director of the Prostate Cancer Foundation of Chicago and the Chicago Prostate Cancer Center.  This procedure is also a stepping stone towards focal therapy, where more limited treatment can result in less side effects, yet achieve cure rates equal to more radical forms of treatment. "


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