Fear of prostate biopsy: a limitation in the management of prostate cance

Abstract

The incidence of prostate cancer is increasing in the country and now constitutes 11% of allmale cancers. For diagnosis of prostate cancer, a histological diagnosis is necessary and this requires that a prostate biopsy be performed but patientsmay not readily accept this invasive procedure. A 2-year retrospective study was carried out in Baptist Medical Centre, Eku, Delta State from January1 2004 toDecember 31 2005; datawere collected from case notes of patientswho had serum prostate specific antigen (PSA) done to review the response of patients to the offer of prostate biopsy after an elevated serumprostate specific antigen result. There were 65 patients aged between 48years to 97years, mean age was 71years. 45 patients were offered prostate biopsy based on elevated serum prostate specific antigen (PSA) and/or findings on digital rectal examination (DRE). Only 12 (26.67%) accepted and of these, 4 (33.33%) had a histological diagnosis of adenocarcinoma of the prostrate. Our study has shown that majority of symptomatic prostate cancer patients refuse biopsy regardless of adequate counseling.

Keywords: Prostate biopsy, digital rectal examination, prostate-specific antigen, prostate cancer